# GLENWOOD ESTATE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GLENWOOD ESTATE, INC.
- **Other names:** Regal Estate of Glenwood
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1932157708
- **Legal business name:** GLENWOOD ESTATE, INC.
- **Authorized official:** MARY ANN POLLOCK (OWNER)
- **Authorized official phone:** (620) 331-8789

## Contact information

- **Practice address:** 1000 MULBERRY ST, INDEPENDENCE, KS 67301-2026
- **Practice address phone:** (620) 331-8789
- **Practice address fax:** (620) 331-6895
- **Mailing address:** 1000 MULBERRY ST, P.O. BOX 627, INDEPENDENCE, KS 67301-2026
- **Mailing address phone:** (620) 331-8789
- **Mailing address fax:** (620) 331-6895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | N063017 | KS | — |
| 314000000X | Skilled Nursing Facility | N063017 | KS | Yes |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 04/27/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100108260A | — | KS |
| 01 | — | 800 | BLUE CROSS BLUE SHIELD | KS |