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General NPI Number Information
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NPI Number | 1992248629
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Entity Type | Organization
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Legal Business Name | REGENT PARK REHABILITATION AND HEALTHCARE
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 10604 E 13TH ST N
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City | WICHITA
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State | KS
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Zip | 67206-3706
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Country | US
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Telephone | 316-337-5450
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Fax | 316-558-5259
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Provider Business Mailing Address
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Address Line | 13408 E TALLOWOOD DR
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City | WICHITA
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State | KS
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Zip | 67230-1766
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Country | US
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Telephone | 316-616-4924
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Fax | 316-558-5259
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Authorized Official
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Title or Position | DIRECTOR OF REHABILITATION
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Name | HEATHER M. BERRY
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Credential | OTR/L
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Telephone | 316-337-5450
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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 | 17-02419
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License Number State | KS
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