# VINTAGE PARK AT OSAWATOMIE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235174749
- **Authorized official:** EDDIE PARADES (SR VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (210) 493-3165

## Contact information

- **Practice address:** 1520 PARKER AVE, OSAWATOMIE, KS 66064-1702
- **Practice address phone:** (913) 755-2167
- **Practice address fax:** (913) 755-4855
- **Mailing address:** 1520 PARKER AVE, OSAWATOMIE, KS 66064-1702
- **Mailing address phone:** (913) 755-2167
- **Mailing address fax:** (913) 755-4855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | NO61009 | KS | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 08/22/2020