# MEDICALODGES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gran Villas Great Bend
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720561541
- **Authorized official:** SCOTT HINES (CFO)
- **Authorized official phone:** (620) 709-0305

## Contact information

- **Practice address:** 1401 CHERRY LN, GREAT BEND, KS 67530-3152
- **Practice address phone:** (620) 792-2165
- **Practice address fax:** (620) 793-6341
- **Mailing address:** 1401 CHERRY LN, GREAT BEND, KS 67530-3152
- **Mailing address phone:** (620) 792-2165
- **Mailing address fax:** (620) 793-6341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2018
- **Last updated:** 09/07/2018