Provider Demographics
NPI:1467029439
Name:LANDMARK OF KUTTAWA A REHABILITATION & NURSING CENTER LL
Entity Type:Organization
Organization Name:LANDMARK OF KUTTAWA A REHABILITATION & NURSING CENTER LL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEISELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-664-3925
Mailing Address - Street 1:6101 NIMTZ PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-6111
Mailing Address - Country:US
Mailing Address - Phone:269-281-4200
Mailing Address - Fax:
Practice Address - Street 1:1253 LAKE BARKLEY DR
Practice Address - Street 2:
Practice Address - City:KUTTAWA
Practice Address - State:KY
Practice Address - Zip Code:42055-6124
Practice Address - Country:US
Practice Address - Phone:270-388-2291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility