Organization
PIONEER COMMUNITY CARE, INC. DBA PIONEER LODGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA L. THOMPSON (ADMINSISTRATOR)
(620) 582-2123
Entity
Organization
Contact information
Practice address
300 W 3RD ST, COLDWATER, KS 67029-7300
(620) 582-2123
(620) 582-2461
Mailing address
PO BOX 487, COLDWATER, KS 67029-0487
(620) 582-2123
(620) 582-2461
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N-017-001
—
KS
Enumeration date
11/21/2005
Last updated
03/29/2011
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