# THI OF KANSAS AT INDIAN CREEK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Indian Creek Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407943699
- **Authorized official:** GLENNA CALDWELL (PRESIDENT)
- **Authorized official phone:** (913) 642-5545

## Contact information

- **Practice address:** 6515 W 103RD ST, OVERLAND PARK, KS 66212-1728
- **Practice address phone:** (913) 642-5545
- **Practice address fax:** (913) 642-3982
- **Mailing address:** 920 RIDGEBROOK RD, SPARKS, MD 21152-9390
- **Mailing address phone:** (410) 773-1000

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2006
- **Last updated:** 06/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1042125101 | — | KS |