Healthcare Provider Details

I. General information

NPI: 1417942327
Provider Name (Legal Business Name): MENNONITE FRIENDSHIP COMMUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W BLANCHARD AVE
SOUTH HUTCHINSON KS
67505-1526
US

IV. Provider business mailing address

600 W BLANCHARD AVE
SOUTH HUTCHINSON KS
67505-1526
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-7175
  • Fax: 620-663-4221
Mailing address:
  • Phone: 620-663-7175
  • Fax: 620-663-4221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN078005
License Number StateKS

VIII. Authorized Official

Name: MR. MARK L OSWALD
Title or Position: CHIEF FINANCIAL OFFICER (CFO)
Credential:
Phone: 620-663-7175