Deer Park Senior Group Homes LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

B044001 Issued in KS

Legal business name

DEER PARK SENIOR GROUP HOMES LLC

Practice address

6313 Highway K4
Meriden, KS 66512-9220

Phone

(785) 484-2165

NPI assigned

Sep 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Laura M Rich-Forbes

Title

Operator

Phone

(785) 484-2165

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1326234535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6313 HIGHWAY K4",
            "city": "MERIDEN",
            "state": "KS",
            "postal_code": "665129220",
            "telephone_number": "785-484-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6313 HIGHWAY K4",
            "city": "MERIDEN",
            "state": "KS",
            "postal_code": "665129220",
            "telephone_number": "785-484-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK SENIOR GROUP HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "RICH-FORBES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "785-484-2165",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "KS",
            "license": "B044001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00102216588",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00102102889",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00100436750",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• BBF Pharmacy Inc
• Andrea R Beaman, APRN
• April K Boatwright
• Deer Park Senior Group Home Inc.
• Faith Counseling & Wellness Center
• Molly Ann Freeman, FNP-BC
• FW Huston Pharmacy of Meriden
• Kayla Renee Gardner, LMSW
• Jefferson West Usd340

• Adult Care Home Facility in Meriden, KS
• Providers in Meriden, KS by specialty
• Adult Care Home Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.