Organization
KANSAS MASONIC HOME, INC.
Active
Other names
Kansas Masonic Home
Organization subpart
No
Provider details
NPI number
Authorized official
TIM NIKKEL (DIRECTOR OF FINANCE)
(316) 269-7652
Entity
Organization
Contact information
Practice address
401 S SENECA ST, WICHITA, KS 67213-5541
(316) 269-7500
(316) 267-2199
Mailing address
401 S SENECA ST, WICHITA, KS 67213-5541
(316) 269-7500
(316) 267-2199
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N087055
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10016680B
—
KS
01
—
N087055
STATE LICENSE
KS
Enumeration date
03/13/2007
Last updated
08/22/2020
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