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Organization

GLENWOOD ESTATE, INC.

Active
Other names
Heatherwood Estate
Organization subpart
No

Provider details

NPI number
Authorized official
LAURIE NELL HAMILTON (OFFICE MANAGER)
(620) 331-0511
Entity
Organization

Contact information

Practice address
614 S 8TH ST, INDEPENDENCE, KS 67301-4205
(620) 331-0511
(620) 331-0599
Mailing address
614 S 8TH ST, INDEPENDENCE, KS 67301-4205
(620) 331-0511
(620) 331-0599

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N063008
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100110020A
KS
01
1657
BLUE CROSS BLUE SHIELD
KS
Enumeration date
09/16/2006
Last updated
11/04/2008
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