Healthcare Provider Details

I. General information

NPI: 1619071933
Provider Name (Legal Business Name): PRESBYTERIAN MANORS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 KASOLD DR
LAWRENCE KS
66049-3425
US

IV. Provider business mailing address

PO BOX 20440
WICHITA KS
67208-1440
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-4262
  • Fax: 785-841-0923
Mailing address:
  • Phone: 316-685-1100
  • Fax: 316-685-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN/A
License Number StateKS

VIII. Authorized Official

Name: MR. WILLIAM M WARD JR.
Title or Position: PRESIDENT/CEO
Credential:
Phone: 316-685-1100