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NPI Code Detail

MEDICARE: CENTERS FOR LONG TERM CARE OF OLATHE, INC

MEDICARE: CENTERS FOR LONG TERM CARE OF OLATHE, INC
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 Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225099393
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTERS FOR LONG TERM CARE OF OLATHE, INC
Provider Business Mailing Address
First Line : PO BOX 155635
Second Line :
City : FORT WORTH
State : TX
Zip : 76155-0635
Country : US
Telephone Number : 817-359-2000
Fax Number : 817-359-2093
Provider Business Practice Location Address
First Line : 400 S ROGERS RD
Second Line :
City : OLATHE
State : KS
Zip : 66062-1706
Country : US
Telephone Number : 913-782-3350
Fax Number : 913-782-1732
Authorized Official
Title or Position : CEO
Name : GARY TREBERT
Credential :
Telephone Number : 817-359-2000
Provider Enumeration Date : 03/29/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1235005976 — RYLIE EDWARDS APRN
Practice Location Address:
480 S ROGERS RD
OLATHE, KS
66062-1706
Practice Phone: 913-764-2887
Practice Fax:
1316528821 — HEATHER LYNN BAKER
Practice Location Address:
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OLATHE, KS
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1376516187 — TARA STRONG LCP
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1043245111 — JEFFREY M PETERS LMSW
Practice Location Address:
480 S ROGERS RD
OLATHE, KS
66062-1706
Practice Phone: 913-780-3387
Practice Fax:
1922182096 — PINNACLE HEALTH FACILITIES XVIII LP
Practice Location Address:
400 S ROGERS RD
OLATHE, KS
66062-1706
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1730248626 — MR. BRANDON JAMES MOCK ATR-BC, LPC, LMFT
Practice Location Address:
480 S ROGERS RD
OLATHE, KS
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Practice Fax: 913-780-3387

Directions to “CENTERS FOR LONG TERM CARE OF OLATHE, INC ” Practice Location

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