Organization
COUNTRYSIDE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANNITY MARIE FARLEY REGISTEREDNURSE (OWNER OPERATOR)
(620) 326-8749
Entity
Organization
Contact information
Practice address
122 S COUNTRYSIDE LN, WELLINGTON, KS 67152-8077
(620) 326-8749
(620) 326-2254
Mailing address
122 S COUNTRYSIDE LN, WELLINGTON, KS 67152-8077
(620) 326-8749
(620) 326-2254
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
B096014
KS
Other
Enumeration date
03/01/2007
Last updated
07/14/2008
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