Organization
MEMORIAL HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON T STUCKY (CEO)
(620) 345-2901
Entity
Organization
Contact information
Practice address
86 22ND AVE, MOUNDRIDGE, KS 67107-7003
(620) 345-2901
(620) 345-2937
Mailing address
86 22ND AVE, MOUNDRIDGE, KS 67107-7003
(620) 345-2901
(620) 345-2937
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108790
—
KS
Enumeration date
07/21/2005
Last updated
07/17/2023
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