Organization
HOMESTEAD OF RUSSELL OPERATIONS, LLC
Active
Other names
Homestead of Russell
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D TRYON CPA (CFO)
(785) 272-1535
Entity
Organization
Contact information
Practice address
1070 E WICHITA AVE, RUSSELL, KS 67665-2409
(785) 483-5882
(785) 483-2797
Mailing address
3715 SW 29TH ST STE 200, TOPEKA, KS 66614-2164
(785) 272-1535
(785) 272-1480
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N084007
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N084007
—
KS
Enumeration date
01/04/2017
Last updated
01/04/2017
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