Organization
LEISURE HOMESTEAD ASSOCIATION
Active
Other names
LEISURE HOMESTEAD AT ST JOHN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES SCOTT YOUNIE (ADMINISTRATOR)
(620) 549-3541
Entity
Organization
Contact information
Practice address
402 N SANTA FE ST, SAINT JOHN, KS 67576-1800
(620) 549-3541
(620) 549-3590
Mailing address
402 N SANTA FE ST, SAINT JOHN, KS 67576-1800
(620) 549-3541
(620) 549-3590
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N098001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100110450A
—
KS
01
—
161495
AAHSA ID NO
—
01
—
17E607
FEDERAL PROVIDER NO
—
Enumeration date
02/14/2007
Last updated
01/20/2022
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