Healthcare Provider Details

I. General information

NPI: 1891905972
Provider Name (Legal Business Name): HICKORY POINTE CARE AND REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHEROKEE ST
OSKALOOSA KS
66066-5054
US

IV. Provider business mailing address

700 CHEROKEE ST
OSKALOOSA KS
66066-5054
US

V. Phone/Fax

Practice location:
  • Phone: 785-863-2108
  • Fax:
Mailing address:
  • Phone: 785-863-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN044001
License Number StateKS

VIII. Authorized Official

Name: JIM MERCIER
Title or Position: ADMINISTRATOR
Credential:
Phone: 785-863-2108