# GARDEN VALLEY RETIREMENT VILLAGE, LLC

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

## Provider details

- **NPI number:** 1710210943
- **Authorized official:** DEAN KIKLIS (CFO)
- **Authorized official phone:** (303) 952-9216

## Contact information

- **Practice address:** 1505 EAST SPRUCE STREET, GARDEN CITY, KS 67846
- **Practice address phone:** (620) 275-9651
- **Practice address fax:** (620) 275-6582
- **Mailing address:** 1505 EAST SPRUCE STREET, GARDEN CITY, KS 67846
- **Mailing address phone:** (620) 275-9651
- **Mailing address fax:** (620) 275-6582

## Taxonomy

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

## Other

- **Enumeration date:** 09/04/2009
- **Last updated:** 05/26/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1041134501 | — | KS |