Organization
LAUREL LAKE HEALTH AND REHABILITATION, L.L.C.
Active
Other names
Kindred Nursing and Rehabilitation-Laurel Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
620 LAUREL ST, LEE, MA 01238-9181
(413) 243-2010
(413) 243-4288
Mailing address
680 S 4TH ST # KH-2, LOUISVILLE, KY 40202-2407
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0008
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000026404
BMC HEALTH NET
MA
01
—
00925381
MARTINS POINT
MA
05
—
0921271
—
MA
01
—
1005195
AETNA
MA
01
—
2222574901
BLUE CROSS BLUE SHIELD
MA
01
—
225749
CCS
MA
Enumeration date
08/30/2006
Last updated
12/12/2017
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