Organization
MISSION VILLAGE LIVING CENTER, INC
Active
Other names
Tri County Manor Living Center, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA RAASCH (ADMIN/CEO)
(785) 486-2697
Entity
Organization
Contact information
Practice address
1890 EUCLID AVENUE, HORTON, KS 66439
(785) 486-2697
(785) 486-2359
Mailing address
1890 EUCLID AVENUE, HORTON, KS 66439
(785) 486-2697
(785) 486-2359
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
KS
310400000X
Assisted Living Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
KS
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107420A
—
KS
01
—
100107420B
PROFESSIONAL
KS
Enumeration date
01/26/2007
Last updated
08/10/2015
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