Provider Demographics
NPI:1922177997
Name:KINDRED HOSPITALS LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:KINDRED HOSPITALS LIMITED PARTNERSHIP
Other - Org Name:KINDRED HOSPITAL - MANSFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
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 1:1802 HIGHWAY 157 N
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3923
Mailing Address - Country:US
Mailing Address - Phone:817-473-6101
Mailing Address - Fax:817-473-8541
Practice Address - Street 1:1802 HIGHWAY 157 N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3923
Practice Address - Country:US
Practice Address - Phone:817-473-6101
Practice Address - Fax:817-473-8541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000657282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH0772OtherBLUE CROSS
TX021004901Medicaid
TX=========OtherUNITED HEALTHCARE
TX=========OtherAETNA
TX=========OtherPACIFICARE
TX021004901Medicaid
TX=========OtherGREAT WEST
TX=========OtherTRICARE CHAMPUS
TX=========OtherSECURE HORIZONS
TXHH0772OtherBLUE CROSS
45-2019Medicare Oscar/Certification