Organization
KINDRED NURSING CENTERS WEST, LLC
Active
Other names
Kindred Nursing and Rehabilitation-Hacienda
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A. WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
660 S CORONADO DR, SIERRA VISTA, AZ 85635-3386
(520) 459-4900
(520) 458-4082
Mailing address
680 S 4TH ST # KH-2, LOUISVILLE, KY 40202-2407
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-338
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266354
UNITED HEALTHCARE
AZ
01
—
633489
MERCY CARE
AZ
05
—
633489
—
AZ
01
—
AZ0207100
BLUE CROSS/BLUE SHIELD AZ
AZ
Enumeration date
11/01/2006
Last updated
11/29/2017
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