Healthcare Provider Details

I. General information

NPI: 1982695417
Provider Name (Legal Business Name): SUNSET HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 2ND AVE
CONCORDIA KS
66901-2727
US

IV. Provider business mailing address

620 2ND AVE
CONCORDIA KS
66901-2727
US

V. Phone/Fax

Practice location:
  • Phone: 785-243-2720
  • Fax: 785-243-1576
Mailing address:
  • Phone: 785-243-2720
  • Fax: 785-243-1576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN-015006
License Number StateKS

VIII. Authorized Official

Name: MR. LARRY L BLOCHLINGER
Title or Position: ADMINISTRATOR
Credential:
Phone: 785-243-2720