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Organization
CITY OF STOCKTON
Active
Organization
CITY OF STOCKTON
Active
Other names
Solomon Valley Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH SCHLAEGEL (CITY MANAGER)
(785) 425-6703
Entity
Organization
Contact information
Practice address
315 S ASH ST, STOCKTON, KS 67669-2136
(785) 425-6754
(785) 425-6755
Mailing address
315 S ASH ST, STOCKTON, KS 67669-2136
(785) 425-6754
(785) 425-6755
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N082002
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001654
BCBSKS (SNF)
KS
01
—
048199
BCBSKS (DME)
KS
05
—
100110720A
—
KS
01
—
17E637
MEDICAID NUMBER
KS
Enumeration date
08/31/2006
Last updated
09/25/2012
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