# SENIORTRUST OF COUNCIL GROVE, LLC

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

## Provider details

- **NPI number:** 1508804998
- **Authorized official:** ROBERT WEBB (PRESIDENT)
- **Authorized official phone:** (615) 893-2749

## Contact information

- **Practice address:** 400 SUNSET DR, COUNCIL GROVE, KS 66846-1554
- **Practice address phone:** (620) 767-5172
- **Mailing address:** 400 SUNSET DR, COUNCIL GROVE, KS 66846-1554
- **Mailing address phone:** (620) 767-5172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N064001 | KS | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 900 | BCBS KS | KS |