Provider Demographics
NPI:1861577439
Name:KINDRED HOSPITALS WEST, LLC
Entity type:Organization
Organization Name:KINDRED HOSPITALS WEST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:JOHNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-6063
Mailing Address - Street 1:680 S 4TH ST
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:502-596-6063
Mailing Address - Fax:
Practice Address - Street 1:1920 HIGH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1213
Practice Address - Country:US
Practice Address - Phone:303-320-5871
Practice Address - Fax:303-377-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0327282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05093000Medicaid
CO37819KIOtherBLUE CROSS
CO05093000Medicaid
CO37819KIOtherBLUE CROSS
CO=========OtherPACIFICARE
CO=========OtherGREAT WEST
CO=========OtherSECURE HORIZONS
CO=========OtherUNITED HEALTHCARE
CO=========OtherAETNA
CO=========OtherKAISER PERMENENTE
CO05093000Medicaid