Organization
GLENWOOD ESTATE, INC.
Active
Parent organization
GLENWOOD ESTATE, INC.
Other names
Regal Estate of Glenwood
Organization subpart
Yes
Provider details
NPI number
Legal business name
GLENWOOD ESTATE, INC.
Authorized official
MARY ANN POLLOCK (OWNER)
(620) 331-8789
Entity
Organization
Contact information
Practice address
1000 MULBERRY ST, INDEPENDENCE, KS 67301-2026
(620) 331-8789
(620) 331-6895
Mailing address
1000 MULBERRY ST, P.O. BOX 627, INDEPENDENCE, KS 67301-2026
(620) 331-8789
(620) 331-6895
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
N063017
KS
314000000X
Skilled Nursing Facility
Primary
N063017
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108260A
—
KS
01
—
800
BLUE CROSS BLUE SHIELD
KS
Enumeration date
05/04/2006
Last updated
04/27/2009
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