Organization
SENIORTRUST OF COUNCIL GROVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WEBB (PRESIDENT)
(615) 893-2749
Entity
Organization
Contact information
Practice address
400 SUNSET DR, COUNCIL GROVE, KS 66846-1554
(620) 767-5172
Mailing address
400 SUNSET DR, COUNCIL GROVE, KS 66846-1554
(620) 767-5172
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N064001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900
BCBS KS
KS
Enumeration date
06/04/2006
Last updated
08/22/2020
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