Organization
VINTAGE PARK AT OSAGE CITY, LLC
Active
Other names
Vintage Park at Osage City
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT MOORE (PRESIDENT)
(949) 282-5800
Entity
Organization
Contact information
Practice address
1403 LAING ST, OSAGE CITY, KS 66523-9203
(785) 528-5095
(785) 528-4867
Mailing address
1403 LAING ST, OSAGE CITY, KS 66523-9203
(785) 528-5095
(785) 528-4867
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BEING APPLIED FOR
—
KS
Enumeration date
08/29/2008
Last updated
08/29/2008
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