Healthcare Provider Details

I. General information

NPI: 1306023189
Provider Name (Legal Business Name): HMG PARK MANOR OF SALINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 JOHNSTOWN AVE
SALINA KS
67401-3021
US

IV. Provider business mailing address

1780 HUGHES LANDING BLVD STE 500
THE WOODLANDS TX
77380-4009
US

V. Phone/Fax

Practice location:
  • Phone: 785-823-7101
  • Fax: 785-823-7631
Mailing address:
  • Phone: 281-419-5520
  • Fax: 281-419-5527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN085006
License Number StateKS

VIII. Authorized Official

Name: MR. LAURENCE C. DASPIT
Title or Position: CFO
Credential:
Phone: 281-419-5520