Healthcare Provider Details

I. General information

NPI: 1982604450
Provider Name (Legal Business Name): SPRING VIEW MANOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 S 8TH ST
CONWAY SPRINGS KS
67031-8252
US

IV. Provider business mailing address

412 S 8TH ST
CONWAY SPRINGS KS
67031-8252
US

V. Phone/Fax

Practice location:
  • Phone: 620-456-2285
  • Fax: 620-456-2323
Mailing address:
  • Phone: 620-456-2285
  • Fax: 620-456-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN096006
License Number StateKS

VIII. Authorized Official

Name: MS. VIRGINIA C WINTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 620-456-2285