# CHEYENNE LODGE INC.

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

## Provider details

- **NPI number:** 1568433076
- **Authorized official:** MR. JOSEPH FUENTEZ (ADMINISTRATOR)
- **Authorized official phone:** (785) 439-6211

## Contact information

- **Practice address:** 716 CEDAR ST, JAMESTOWN, KS 66948-3007
- **Practice address phone:** (785) 439-6211
- **Practice address fax:** (785) 439-6210
- **Mailing address:** 716 CEDAR ST, JAMESTOWN, KS 66948-3007
- **Mailing address phone:** (785) 439-6211
- **Mailing address fax:** (785) 439-6210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | N-015-001 | KS | Yes |
| 314000000X | Skilled Nursing Facility | N-015-001 | KS | — |

## Other

- **Enumeration date:** 02/01/2006
- **Last updated:** 09/11/2025