# CHERRY VILLAGE BENEVOLENCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cherry Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144345919
- **Authorized official:** MRS. PAMLA SUE LEWIS R.N. (ADMINISTRATOR)
- **Authorized official phone:** (620) 792-2165

## Contact information

- **Practice address:** 1401 CHERRY LN, GREAT BEND, KS 67530-3152
- **Practice address phone:** (620) 792-2165
- **Practice address fax:** (620) 793-6341
- **Mailing address:** 1401 CHERRY LN, GREAT BEND, KS 67530-3152
- **Mailing address phone:** (620) 792-2165
- **Mailing address fax:** (620) 793-6341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | N005001 | KS | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 31400000X | TAXONOMY | KS |