Organization
CHERRY VILLAGE BENEVOLENCE, INC.
Active
Other names
Cherry Village
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMLA SUE LEWIS R.N. (ADMINISTRATOR)
(620) 792-2165
Entity
Organization
Contact information
Practice address
1401 CHERRY LN, GREAT BEND, KS 67530-3152
(620) 792-2165
(620) 793-6341
Mailing address
1401 CHERRY LN, GREAT BEND, KS 67530-3152
(620) 792-2165
(620) 793-6341
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
N005001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31400000X
TAXONOMY
KS
Enumeration date
03/20/2007
Last updated
08/22/2020
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