MEDICARE: HOMESTEAD HEALTH CENTER, 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
1	314000000X	Skilled Nursing Facility	N087006	KS

Other Identifiers

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

General Provider Information

NPI Number	:	1336253764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMESTEAD HEALTH CENTER, INC

Provider Business Mailing Address
First Line	:	2133 S. ELIZABETH
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67213-3403
Country	:	US
Telephone Number	:	316-262-4473
Fax Number	:	316-262-5939

Provider Business Practice Location Address
First Line	:	2133 S. ELIZABETH
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67213-3403
Country	:	US
Telephone Number	:	316-262-4473
Fax Number	:	316-262-5939

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. NANCY E. VESTRING
Credential	:	ADULT CARE HOME ADMI
Telephone Number	:	316-262-4473

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	09/18/2013

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Directions to “HOMESTEAD HEALTH CENTER, INC ” Practice Location

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