Organization
WHEAT STATE MANOR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E SMITH (ADMINISTRATOR)
(316) 799-2181
Entity
Organization
Contact information
Practice address
601 S MAIN ST, WHITEWATER, KS 67154-9700
(316) 799-2181
(316) 799-2962
Mailing address
601 S MAIN ST, WHITEWATER, KS 67154-9700
(316) 799-2181
(316) 799-2962
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N008006
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001520
BCBSKS
KS
05
—
100107400A
—
KS
Enumeration date
09/19/2005
Last updated
04/12/2010
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