Organization
CUMBERNAULD VILLAGE, INC.
Active
Other names
Cumbernauld Village
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE BLAKE (PRESIDENT OF THE BOARD OF DIRECTORS)
(620) 221-6924
Entity
Organization
Contact information
Practice address
716 TWEED OFC, WINFIELD, KS 67156-1596
(620) 221-4141
(620) 221-4146
Mailing address
716 TWEED OFC OFC, WINFIELD, KS 67156-1595
(620) 221-4141
(620) 221-4146
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N018009
KS
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111960A
—
KS
Enumeration date
01/30/2007
Last updated
10/22/2021
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