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Organization
PRISCILLA C NELSON
Active
Organization
PRISCILLA C NELSON
Active
Other names
Bethel House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PRISCILLA CHRISTINE BACCI (OWNER)
(316) 371-6563
Entity
Organization
Contact information
Practice address
1316 N CHARLOTTE, WICHITA, KS 67208
(316) 440-4406
(316) 440-4407
Mailing address
1842 TARA FALLS CT, WICHITA, KS 67207-6570
(316) 440-4406
(316) 201-1015
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
B087145
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200400780A
—
KS
05
—
200543750A
—
KS
Enumeration date
04/13/2007
Last updated
07/24/2008
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