# MISSION VILLAGE LIVING CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tri County Manor Living Center, Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346396058
- **Authorized official:** PATRICIA RAASCH (ADMIN/CEO)
- **Authorized official phone:** (785) 486-2697

## Contact information

- **Practice address:** 1890 EUCLID AVENUE, HORTON, KS 66439
- **Practice address phone:** (785) 486-2697
- **Practice address fax:** (785) 486-2359
- **Mailing address:** 1890 EUCLID AVENUE, HORTON, KS 66439
- **Mailing address phone:** (785) 486-2697
- **Mailing address fax:** (785) 486-2359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | KS | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | KS | — |
| 314000000X | Skilled Nursing Facility | — | KS | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 08/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100107420A | — | KS |
| 01 | — | 100107420B | PROFESSIONAL | KS |