Organization
VINTAGE PARK AT TONGANOXIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT MOORE (PRESIDENT)
(949) 282-5800
Entity
Organization
Contact information
Practice address
120 W. 8TH STREET, TONGANOXIE, KS 66086
(913) 845-2204
(913) 845-2358
Mailing address
120 W. 8TH STREET, TONGANOXIE, KS 66086
(913) 845-2204
(913) 845-2358
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N052008
KS
Other
Enumeration date
05/22/2009
Last updated
05/22/2009
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