| NPI | 1881682490 |
|---|---|
| Doing Business As | COUNTRY CARE ON BROADWAY |
| Entity Type | Organization |
| Authorized Contact | TAMARA K O'DONNELL Owner 913-680-0306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KS N052004) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2020-08-22 |