| NPI | 1790770287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MARTIN Administrator 316-540-3691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KS 100108890a) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: KS 100108890a) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2024-10-16 |