# PIONEER COMMUNITY CARE, INC. DBA PIONEER LODGE

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

## Provider details

- **NPI number:** 1831172154
- **Authorized official:** MRS. DIANA L. THOMPSON (ADMINSISTRATOR)
- **Authorized official phone:** (620) 582-2123

## Contact information

- **Practice address:** 300 W 3RD ST, COLDWATER, KS 67029-7300
- **Practice address phone:** (620) 582-2123
- **Practice address fax:** (620) 582-2461
- **Mailing address:** PO BOX 487, COLDWATER, KS 67029-0487
- **Mailing address phone:** (620) 582-2123
- **Mailing address fax:** (620) 582-2461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | KS | Yes |

## Other

- **Enumeration date:** 11/21/2005
- **Last updated:** 03/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | N-017-001 | — | KS |