# CEDAR LAKE VILLAGE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HOEGER HOUSE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255345427
- **Authorized official:** MS. JOANNA RANDALL (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (913) 780-9917

## Contact information

- **Practice address:** 20911 W 153RD ST, OLATHE, KS 66061
- **Practice address phone:** (913) 397-2900
- **Practice address fax:** (913) 397-2895
- **Mailing address:** 20911 W 153RD ST, OLATHE, KS 66061
- **Mailing address phone:** (913) 397-2900
- **Mailing address fax:** (913) 397-2895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | KS | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 07/22/2014