Healthcare Provider Details

I. General information

NPI: 1093798373
Provider Name (Legal Business Name): FIVE STAR QUALITY CARE-KS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 INVERNESS DRIVE
LAWRENCE KS
66047-1870
US

IV. Provider business mailing address

1501 INVERNESS DRIVE
LAWRENCE KS
66047-1870
US

V. Phone/Fax

Practice location:
  • Phone: 785-838-8000
  • Fax: 785-838-8001
Mailing address:
  • Phone: 785-838-8000
  • Fax: 785-838-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberN023009
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberN023009
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN023009
License Number StateKS

VIII. Authorized Official

Name: KATHERINE E POTTER
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 617-796-8387