Organization
WEST CENTRAL KANSAS ASSOCIATION, INC.
Active
Other names
Russell Regional Hospital Main Street Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CAUDILL (CEO)
(785) 483-0708
Entity
Organization
Contact information
Practice address
200 S MAIN ST, RUSSELL, KS 67665-2920
(785) 483-3131
(785) 483-4859
Mailing address
200 S MAIN ST, RUSSELL, KS 67665-2920
(785) 483-3131
(785) 483-4859
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
H084001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100445660A
—
KS
Enumeration date
07/28/2006
Last updated
11/16/2022
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