Organization
MEDICALODGES, INC.
Active
Other names
Medicalodges Eudora
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT L HINES (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
1415 MAPLE ST, EUDORA, KS 66025-9419
(785) 542-2176
(785) 542-2177
Mailing address
1415 MAPLE ST, EUDORA, KS 66025-9419
(785) 542-2176
(785) 542-2177
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N023003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107330I
—
KS
01
—
N023003
ADULT CARE HOME LICENSE
KS
Enumeration date
11/26/2007
Last updated
07/23/2013
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