# BEVERLY ENTERPRISES - KANSAS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tonganoxie Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992752729
- **Authorized official:** DAVID G MERRELL (VICE PRESIDENT)
- **Authorized official phone:** (479) 201-4840

## Contact information

- **Practice address:** 1010 EAST ST, TONGANOXIE, KS 66086-9557
- **Practice address phone:** (913) 369-8705
- **Mailing address:** 1010 EAST ST, TONGANOXIE, KS 66086-9557
- **Mailing address phone:** (913) 369-8705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1041115301 | — | KS |