| NPI | 1114921798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDIE TAPIA Business Manager 620-221-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 2-09980) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: KS 2-10380) | |
| 310400000X Assisted Living Facility (Licence: KS 2-10380) | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: KS 2-10380) | |
| 314000000X Skilled Nursing Facility (Licence: KS 2-10380) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: KS 2-10380) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2016-01-25 |