Organization
KINDRED NURSING CENTERS WEST, LLC
Active
Other names
Kindred Nursing and Rehabilitation - Mountain Valley
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
601 W CAMERON AVE, KELLOGG, ID 83837-2004
(208) 784-1283
(208) 784-0151
Mailing address
680 S. 4TH STREET, LOUISVILLE, KY 40202-2407
(502) 596-7301
(502) 596-4134
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
39
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010006827
REGENCE BLUE SHIELD
ID
01
—
02618
BLUE CROSS OF IDAHO
ID
05
—
805218200
—
ID
Enumeration date
07/31/2006
Last updated
09/28/2017
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