Organization
JEWELL HEALTH CARE, LLC
Active
Other names
Cheyenne Meadows Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LARSON ATTORNEY (REGISTERED AGENT)
(816) 322-8113
Entity
Organization
Contact information
Practice address
272 W CHEYENNE ST, HOISINGTON, KS 67544-1576
(620) 653-4141
(620) 653-4282
Mailing address
12120 STATE LINE RD # 372, LEAWOOD, KS 66209-1254
(816) 322-8113
(816) 322-6671
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
N005003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000771
BCBS PROVIDER NUMBER
KS
Enumeration date
05/18/2007
Last updated
08/22/2020
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