Healthcare Provider Details

I. General information

NPI: 1881665420
Provider Name (Legal Business Name): BALDWIN HEALTHCARE AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 ORCHARD LANE
BALDWIN CITY KS
66006
US

IV. Provider business mailing address

1223 ORCHARD LANE
BALDWIN CITY KS
66006
US

V. Phone/Fax

Practice location:
  • Phone: 785-594-6492
  • Fax: 785-594-2854
Mailing address:
  • Phone: 785-594-6492
  • Fax: 785-594-2854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN023001
License Number StateKS

VIII. Authorized Official

Name: MICHAEL T. BERG
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 505-468-4752