Organization
COUNTRYSIDE HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAM J MARTIN (OWNER OPERATOR)
(785) 263-7197
Entity
Organization
Contact information
Practice address
2454 HWY 15 NORTH, ABILENE, KS 67410-6084
(785) 263-7197
(785) 263-9885
Mailing address
2454 HWY 15 NORTH, ABILENE, KS 67410-6084
(785) 263-7197
(785) 263-9885
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N021006
KS
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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