Provider Demographics
NPI:1841211703
Name:KINDRED NURSING CENTERS EAST, L.L.C.
Entity Type:Organization
Organization Name:KINDRED NURSING CENTERS EAST, L.L.C.
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:502-596-7563
Mailing Address - Street 1:680 S 4TH ST # KH-2
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:
Mailing Address - Fax:
Practice Address - Street 1:160 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-4037
Practice Address - Country:US
Practice Address - Phone:508-660-3080
Practice Address - Fax:508-660-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0929314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4442557OtherAETNA
MA805005OtherTUFTS
MA1471950OtherUNITED HEALTH CARE
MA0926515Medicaid
MA2222553601OtherBLUE CROSS BLUE SHIELD
MA001388OtherSENIOR WHOLE HEALTH
MA903333OtherHPHC
MA001388OtherSENIOR WHOLE HEALTH