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General NPI Number Information
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NPI Number | 1679111413
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Entity Type | Organization
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Legal Business Name | COMFORTCARE HOMES OF BALDWIN CITY, LLC
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 424 WASHINGTON ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-5100
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Country | US
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Telephone | 785-594-5625
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Fax | 785-594-0289
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Provider Business Mailing Address
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Address Line | PO BOX 445
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City | BALDWIN CITY
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State | KS
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Zip | 66006-0445
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Country | US
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Telephone | 785-594-2603
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | SCOTT DAVID SCHULTZ
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Credential |
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Telephone | 785-594-2603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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