# WHEAT STATE MANOR, INC

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

## Provider details

- **NPI number:** 1780679498
- **Authorized official:** MR. MICHAEL E SMITH (ADMINISTRATOR)
- **Authorized official phone:** (316) 799-2181

## Contact information

- **Practice address:** 601 S MAIN ST, WHITEWATER, KS 67154-9700
- **Practice address phone:** (316) 799-2181
- **Practice address fax:** (316) 799-2962
- **Mailing address:** 601 S MAIN ST, WHITEWATER, KS 67154-9700
- **Mailing address phone:** (316) 799-2181
- **Mailing address fax:** (316) 799-2962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N008006 | KS | Yes |

## Other

- **Enumeration date:** 09/19/2005
- **Last updated:** 04/12/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001520 | BCBSKS | KS |
| 05 | — | 100107400A | — | KS |