Organization
LAKEWOOD SENIOR LIVING OF PRATT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KENT (EXECUTIVE VICE PRESIDENT)
(205) 320-7554
Entity
Organization
Contact information
Practice address
1221 LARIMER ST, PRATT, KS 67124-1241
(620) 672-6541
Mailing address
3008 7TH AVE S, BIRMINGHAM, AL 35233-3503
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N076002
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200251070A
—
KS
Enumeration date
11/20/2006
Last updated
05/26/2011
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