# KANSAS MASONIC HOME, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kansas Masonic Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841323573
- **Authorized official:** TIM NIKKEL (DIRECTOR OF FINANCE)
- **Authorized official phone:** (316) 269-7652

## Contact information

- **Practice address:** 401 S SENECA ST, WICHITA, KS 67213-5541
- **Practice address phone:** (316) 269-7500
- **Practice address fax:** (316) 267-2199
- **Mailing address:** 401 S SENECA ST, WICHITA, KS 67213-5541
- **Mailing address phone:** (316) 269-7500
- **Mailing address fax:** (316) 267-2199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | N087055 | KS | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10016680B | — | KS |
| 01 | — | N087055 | STATE LICENSE | KS |