# MIDWEST HOMESTEAD OF LEAWOOD OPERATIONS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HOMESTEAD OF LEAWOOD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366502114
- **Authorized official:** MR. MICHAEL D TRYON (CFO)
- **Authorized official phone:** (785) 272-1535

## Contact information

- **Practice address:** 12720 STATE LINE RD, LEAWOOD, KS 66209-1619
- **Practice address phone:** (913) 663-3351
- **Practice address fax:** (913) 894-4147
- **Mailing address:** 3715 SW 29TH ST, TOPEKA, KS 66614-2107
- **Mailing address phone:** (785) 272-1535
- **Mailing address fax:** (785) 272-1480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 200303680A | KS | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 09/19/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200303680A | — | KS |