Provider Demographics
NPI:1407005887
Name:KND DEVELOPMENT 51, LLC
Entity Type:Organization
Organization Name:KND DEVELOPMENT 51, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7300
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:502-596-7301
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:7000 COCHRAN ROAD
Practice Address - Street 2:
Practice Address - City:GLENWILLOW
Practice Address - State:OH
Practice Address - Zip Code:44139-4304
Practice Address - Country:US
Practice Address - Phone:440-914-0900
Practice Address - Fax:440-914-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2017-10-19
Deactivation Date:2008-10-20
Deactivation Code:
Reactivation Date:2010-03-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3036511Medicaid
OH3036511Medicaid