Healthcare Provider Details

I. General information

NPI: 1366493660
Provider Name (Legal Business Name): GGNSC MARION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E LAWRENCE ST
MARION KS
66861-1112
US

IV. Provider business mailing address

1500 E LAWRENCE ST
MARION KS
66861-1112
US

V. Phone/Fax

Practice location:
  • Phone: 620-382-2191
  • Fax: 620-382-2072
Mailing address:
  • Phone: 620-382-2191
  • Fax: 620-382-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN057003
License Number StateKS

VIII. Authorized Official

Name: HOLLY A. RASMUSSEN-JONES
Title or Position: SECRETARY
Credential:
Phone: 479-201-4835