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Organization

HOMESTEAD ESTATES HOME PLUS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE L LOCK-GOOCH (OPERATOR)
(620) 626-5672
Entity
Organization

Contact information

Practice address
1140 S PERSHING AVE, LIBERAL, KS 67901-4519
(620) 626-5672
(620) 626-0895
Mailing address
1140 S PERSHING AVE, LIBERAL, KS 67901-4519
(620) 626-5672
(620) 626-0895

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
B088002
KS

Other

Enumeration date
09/28/2015
Last updated
09/28/2015
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