# PARKSIDE HOMES INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Parkside Homes
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285621862
- **Authorized official:** MRS. GRETCHEN LEIGH WAGNER ACHA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (620) 947-2301

## Contact information

- **Practice address:** 200 WILLOW ROAD, HILLSBORO, KS 67063-1999
- **Practice address phone:** (620) 947-2301
- **Practice address fax:** (620) 947-5608
- **Mailing address:** 200 WILLOW ROAD, HILLSBORO, KS 67063-1999
- **Mailing address phone:** (620) 947-2301
- **Mailing address fax:** (620) 947-5608

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N-057-004 | KS | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 07/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100109240A | — | KS |