Countryside Home

NPI #1598893869 in Wellington, Kansas

Provider Information

NPI Number
1598893869
Entity Type
Organization
Organization Name
Countryside Home
Primary Specialty
Custodial Care Facility - Adult Care Home
Enumeration Date
Mar 1, 2007
Last Updated
Jul 14, 2008

Practice Location

Address
122 S COUNTRYSIDE LN
State
Kansas
ZIP Code
67152-8077
Phone
(620) 326-8749

Authorized Official

Name
MRS. CHANNITY MARIE FARLEY, REGISTEREDNURSE
Title
OWNER OPERATOR
Phone
(620) 326-8749

Specialties & Taxonomy Codes

Specialty
Custodial Care Facility - Adult Care HomeAdult Care Home

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