Basic Information
Provider Information
NPI: 1689303562
EntityType: 2
ReplacementNPI:  
OrganizationName: DIGNITY-KINDRED REHABILITATION HOSPITAL EAST VALLEY, LLC
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Mailing Information
Address1: 330 SEVEN SPRINGS WAY
Address2:  
City: BRENTWOOD
State: TN
PostalCode: 370275098
CountryCode: US
TelephoneNumber: 6159207000
FaxNumber: 5025964134
Practice Location
Address1: 1850 S. SAN TAN VILLAGE PARKWAY
Address2:  
City: GILBERT
State: AZ
PostalCode: 85295
CountryCode: US
TelephoneNumber: 5025967547
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/07/2022
LastUpdateDate: 06/07/2022
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AuthorizedOfficialLastName: DILLON
AuthorizedOfficialFirstName: TERRANCE
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AuthorizedOfficialTitleorPosition: ASSISTANT SECRETARY
AuthorizedOfficialTelephone: 5025967220
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 05/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283X00000X  Y HospitalsRehabilitation Hospital 

No ID Information.


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