# COUNTRY CARE INC.

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

## Provider details

- **NPI number:** 1831171453
- **Authorized official:** MRS. TAMARA KELLY O'DONNELL BSN, RN, MBA, ADMIN (PRESIDENT, COUNTRY CARE, INC)
- **Authorized official phone:** (913) 773-5517

## Contact information

- **Practice address:** 515 DAWSON ST, EASTON, KS 66020-9200
- **Practice address phone:** (913) 773-5517
- **Practice address fax:** (913) 773-5562
- **Mailing address:** 515 DAWSON ST, EASTON, KS 66020-9200
- **Mailing address phone:** (913) 773-5517
- **Mailing address fax:** (913) 773-5562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N052002 | KS | Yes |

## Other

- **Enumeration date:** 11/18/2005
- **Last updated:** 01/18/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100109970A | — | KS |