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General NPI Number Information
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NPI Number | 1376890491
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Entity Type | Organization
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Legal Business Name | WELLSVILLE RETIREMENT COMMUNITY
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Dates
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Enumeration Date | 08/08/2012
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 304 W 7TH ST
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City | WELLSVILLE
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State | KS
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Zip | 66092-7800
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Country | US
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Telephone | 785-883-4101
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Fax | 785-883-2200
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Provider Business Mailing Address
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Address Line | 304 W 7TH ST
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City | WELLSVILLE
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State | KS
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Zip | 66092-7800
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Country | US
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Telephone | 785-883-4101
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Fax | 785-883-2200
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Authorized Official
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Title or Position | REHAB DIRECTOR
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Name | MR. MARK CHRISTOPHER HURLEY
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Credential | CPTA
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Telephone | 785-883-4101
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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 | 14-01971
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License Number State | KS
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