Healthcare Provider Details

I. General information

NPI: 1801882873
Provider Name (Legal Business Name): OSBORNE DEVELOPMENT CO., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 N 1ST ST
OSBORNE KS
67473-1512
US

IV. Provider business mailing address

PO BOX 247 811 N 1ST,
OSBORNE KS
67473-1512
US

V. Phone/Fax

Practice location:
  • Phone: 785-346-2114
  • Fax: 785-346-2491
Mailing address:
  • Phone: 785-346-2114
  • Fax: 785-346-2491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberN071002
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN071002
License Number StateKS

VIII. Authorized Official

Name: DOUGLAS YODER
Title or Position: REGIONAL MANAGER
Credential:
Phone: 785-842-9883