Organization
THI OF KANSAS AT INDIAN CREEK, LLC
Active
Other names
Indian Creek Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
GLENNA CALDWELL (PRESIDENT)
(913) 642-5545
Entity
Organization
Contact information
Practice address
6515 W 103RD ST, OVERLAND PARK, KS 66212-1728
(913) 642-5545
(913) 642-3982
Mailing address
920 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1042125101
—
KS
Enumeration date
10/07/2006
Last updated
06/21/2011
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