Provider Demographics
NPI:1659787356
Name:KINDRED NEVADA, LLC
Entity Type:Organization
Organization Name:KINDRED NEVADA, LLC
Other - Org Name:KINDRED TRANSITIONAL CARE AND REHABILITATION-SPRING VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:5650 S RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1808
Mailing Address - Country:US
Mailing Address - Phone:702-470-1102
Mailing Address - Fax:
Practice Address - Street 1:5650 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1808
Practice Address - Country:US
Practice Address - Phone:702-470-1102
Practice Address - Fax:702-252-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8098SNF-1314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8098SNF-1OtherSTATE OPERATING LICENSE
NV8098SNF-1OtherSTATE OPERATING LICENSE