Healthcare Provider Details

I. General information

NPI: 1164419339
Provider Name (Legal Business Name): WESTY COMMUNITY CARE HOME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N HIGHWAY 99
WESTMORELAND KS
66549-9695
US

IV. Provider business mailing address

105 N HIGHWAY 99
WESTMORELAND KS
66549-9695
US

V. Phone/Fax

Practice location:
  • Phone: 785-457-2801
  • Fax: 785-457-2130
Mailing address:
  • Phone: 785-457-2801
  • Fax: 785-457-2130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN075005
License Number StateKS

VIII. Authorized Official

Name: MICHELLE LYNN RIFFORD
Title or Position: ADMINISTRATOR
Credential: LPN, LNHA
Phone: 785-457-2801