Healthcare Provider Details

I. General information

NPI: 1235604752
Provider Name (Legal Business Name): NORTONVILLE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 WALNUT ST
NORTONVILLE KS
66060
US

IV. Provider business mailing address

111 SHAWNEE ST, STE 211
LEAVENWORTH KS
66048
US

V. Phone/Fax

Practice location:
  • Phone: 913-886-6400
  • Fax:
Mailing address:
  • Phone: 737-212-2674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. KENT LEE MCELROY
Title or Position: MANAGER/CEO
Credential:
Phone: 737-212-2674