| NPI | 1821212705 |
|---|---|
| Doing Business As | PINE PLACE |
| Entity Type | Organization |
| Authorized Contact | BRENDA S SHERWOOD Cep President 785-284-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |