Organization
MEDICALODGES. INC.
Active
Other names
Gran Villas Holton
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY W FISHER (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
410 JUNIPER DR, HOLTON, KS 66436-1535
(785) 364-5051
(785) 364-5010
Mailing address
410 JUNIPER DR, HOLTON, KS 66436-1535
(785) 364-5051
(785) 364-5010
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
N043004
KS
261QA0600X
Adult Day Care Clinic/Center
Primary
N043004
KS
332BC3200X
Customized Equipment (DME)
N043004
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100026530O
—
KS
Enumeration date
10/18/2006
Last updated
06/23/2008
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