Organization
PETERSON ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL W PETERSON (ADMINISTRATOR)
(785) 528-4420
Entity
Organization
Contact information
Practice address
629 HOLLIDAY ST, OSAGE CITY, KS 66523-1137
(785) 528-3301
Mailing address
629 HOLLIDAY ST, OSAGE CITY, KS 66523-1137
(785) 528-3301
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N070007
KS
Other
Enumeration date
02/08/2007
Last updated
08/22/2020
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