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General NPI Number Information
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NPI Number | 1184491359
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Entity Type | Organization
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Legal Business Name | LONE TREE RETIREMENT COMMUNITY LLC
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 801 E GRANT ST
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City | MEADE
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State | KS
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Zip | 67864-9557
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Country | US
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Telephone | 620-873-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 W MAPLE ST
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City | WICHITA
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State | KS
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Zip | 67209-3135
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Country | US
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Telephone | 316-448-0850
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRENDA M KRUSE
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Credential |
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Telephone | 316-500-7930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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