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General NPI Number Information
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NPI Number | 1336253764
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HEALTH CENTER, INC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 2133 S. ELIZABETH
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City | WICHITA
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State | KS
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Zip | 67213-3403
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Country | US
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Telephone | 316-262-4473
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Fax | 316-262-5939
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Provider Business Mailing Address
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Address Line | 2133 S. ELIZABETH
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City | WICHITA
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State | KS
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Zip | 67213-3403
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Country | US
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Telephone | 316-262-4473
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Fax | 316-262-5939
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. NANCY E. VESTRING
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Credential | ADULT CARE HOME ADMI
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Telephone | 316-262-4473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | N087006
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License Number State | KS
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