Organization
KINDRED- HACIENDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
660 S CORONADO DR, SIERRA VISTA, AZ 85635-3386
(520) 459-4900
Mailing address
680 S 4TH ST # KH-2, LOUISVILLE, KY 40202-2407
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SLP0587
AZ
Other
Enumeration date
03/08/2012
Last updated
11/30/2017
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