Provider Demographics
NPI:1164751673
Name:KND DEVELOPMENT 59, LLC
Entity Type:Organization
Organization Name:KND DEVELOPMENT 59, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DVP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7358
Mailing Address - Street 1:680 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:502-596-7358
Mailing Address - Fax:883-501-9731
Practice Address - Street 1:1802 HIGHWAY 157 N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3923
Practice Address - Country:US
Practice Address - Phone:817-473-6101
Practice Address - Fax:502-596-4150
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINDRED HEALTHCARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB109364OtherMEDICARE