Organization
COVENANT PLACE OF LENEXA, INC.
Active
Parent organization
COVENANT RETIREMENT SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT RETIREMENT SERVICES
Authorized official
SCOTT E GULLEDGE (MANAGER)
(913) 890-4782
Entity
Organization
Contact information
Practice address
8505 PFLUMM RD, LENEXA, KS 66215-2461
(913) 307-2000
(913) 322-0200
Mailing address
11827 W 112TH ST, SUITE 103, OVERLAND PARK, KS 66210-2726
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17E644
—
KS
Enumeration date
04/23/2012
Last updated
01/02/2015
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