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NPI Code Detail

MEDICARE: SENIORTRUST OF HAYSVILLE LLC

MEDICARE: SENIORTRUST OF HAYSVILLE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityN087005KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1115670OTHERKSBC BS KS

General Provider Information

NPI Number : 1164477006
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENIORTRUST OF HAYSVILLE LLC
Provider Business Mailing Address
First Line : 215 N LAMAR AVE
Second Line :
City : HAYSVILLE
State : KS
Zip : 67060-1266
Country : US
Telephone Number : 316-524-3211
Fax Number :
Provider Business Practice Location Address
First Line : 215 N LAMAR AVE
Second Line :
City : HAYSVILLE
State : KS
Zip : 67060-1266
Country : US
Telephone Number : 316-524-3211
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOHN MORTON
Credential :
Telephone Number : 615-893-7523
Provider Enumeration Date : 05/22/2006
Last Update Date : 02/20/2008

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Directions to “SENIORTRUST OF HAYSVILLE LLC ” Practice Location

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