# KINGMAN COUNTY RETIREMENT HOME ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Wheatlands Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134286859
- **Authorized official:** MR. MARK KEENY (BOARD PRESIDENT)
- **Authorized official phone:** (620) 532-5801

## Contact information

- **Practice address:** 750 W WASHINGTON AVE, KINGMAN, KS 67068-2000
- **Practice address phone:** (620) 532-5801
- **Practice address fax:** (620) 532-5587
- **Mailing address:** 750 W WASHINGTON AVE, KINGMAN, KS 67068-2000
- **Mailing address phone:** (620) 532-5801
- **Mailing address fax:** (620) 532-5587

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 100072620A | KS | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 100111790A | KS | — |
| 314000000X | Skilled Nursing Facility | 175521 | KS | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 06/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100072620A | — | KS |
| 05 | — | 100111790A | — | KS |