Provider Demographics
NPI:1881855864
Name:KINDRED REHABILITATION SERVICES
Entity Type:Organization
Organization Name:KINDRED REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-446-3817
Mailing Address - Street 1:1550 SILVEIRA PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-4879
Mailing Address - Country:US
Mailing Address - Phone:415-446-3817
Mailing Address - Fax:
Practice Address - Street 1:1550 SILVEIRA PKWY
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4879
Practice Address - Country:US
Practice Address - Phone:415-446-3817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34444314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility