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Organization
MOUNDRIDGE MANOR INC.
Active
Organization
MOUNDRIDGE MANOR INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN W UNRUH (ADMINISTRATOR)
(620) 345-6364
Entity
Organization
Contact information
Practice address
710 NORTH CHRISTIAN AVENUE, MOUNDRIDGE, KS 67107
(620) 345-6364
(620) 345-6376
Mailing address
P.O. BOX 800, MOUNDRIDGE, KS 67107
(620) 345-6364
(620) 345-6376
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N059003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100109430A
—
KS
Enumeration date
02/22/2006
Last updated
06/16/2015
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