# GREAT BEND-LTC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Bend Health & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437435286
- **Authorized official:** DAREN G DOUSTON (MEMBER CFO)
- **Authorized official phone:** (678) 522-2436

## Contact information

- **Practice address:** 1560 K 96 HWY, GREAT BEND, KS 67530-3012
- **Practice address phone:** (678) 522-2436
- **Practice address fax:** (770) 663-4539
- **Mailing address:** 10945 STATE BRIDGE RD, SUITE 401-470, ALPHARETTA, GA 30022-8164
- **Mailing address phone:** (678) 522-2436
- **Mailing address fax:** (770) 663-4539

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2011
- **Last updated:** 11/12/2015