Organization
MEDICALODGES, INC.
Active
Other names
Medicalodges Leavenworth
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT L HINES (CHIEF FINANCIAL OFFICER)
(620) 709-0305
Entity
Organization
Contact information
Practice address
1503 OHIO ST, LEAVENWORTH, KS 66048-2932
(913) 772-1844
(913) 772-1968
Mailing address
1503 OHIO ST, LEAVENWORTH, KS 66048-2932
(913) 772-1844
(913) 772-1968
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N052003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107880A
—
KS
Enumeration date
09/25/2006
Last updated
05/02/2013
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