Healthcare Provider Details

I. General information

NPI: 1629068838
Provider Name (Legal Business Name): KIDRON BETHEL RETIREMENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 IVY DRIVE
NORTH NEWTON KS
67117-8002
US

IV. Provider business mailing address

3001 IVY DRIVE
NORTH NEWTON KS
67117-8002
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-2900
  • Fax: 316-284-0173
Mailing address:
  • Phone: 316-284-2900
  • Fax: 316-284-0173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN040-001
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN-040-001
License Number StateKS

VIII. Authorized Official

Name: JAMES KREHBIEL
Title or Position: CEO
Credential:
Phone: 316-284-2900