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Organization
KANSAS MASONIC HOME, INC.
Active
Organization
KANSAS MASONIC HOME, INC.
Active
Other names
Kansas Masonic Home
Organization subpart
No
Provider details
NPI number
Authorized official
TIM NIKKEL (DIRECTOR OF FINANCE)
(316) 269-7652
Entity
Organization
Contact information
Practice address
401 S SENECA ST, WICHITA, KS 67213-5541
(316) 269-7500
(316) 267-2199
Mailing address
401 S SENECA ST, WICHITA, KS 67213-5541
(316) 269-7500
(316) 267-2199
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N087055
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10016680B
—
KS
01
—
N087055
STATE LICENSE
KS
Enumeration date
03/13/2007
Last updated
08/22/2020
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