# PROTECTION VALLEY MANOR, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447335344
- **Authorized official:** MR. SWEDE CLAYTON SWAGERTY ACHA (ADMINISTRATOR)
- **Authorized official phone:** (620) 622-4261

## Contact information

- **Practice address:** 600 S. BROADWAY, PROTECTION, KS 67127-8801
- **Practice address phone:** (620) 622-4261
- **Practice address fax:** (620) 622-4270
- **Mailing address:** 600 S. BROADWAY, PROTECTION, KS 67127-8801
- **Mailing address phone:** (620) 622-4261
- **Mailing address fax:** (620) 622-4270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NO172002 | KS | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 11/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100109200A | — | KS |