The Legacy at Park View

Organization Active NPI Nursing Facility/Intermediate Care Facility · Ulysses, KS

NPI 1679560932 · NPPES record last updated Oct 10, 2012

Key facts

NPI
1679560932
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
N034001 (KS)
Legal business name
THE LEGACY AT PARK VIEW
Practice address
510 E San Jacinto Ave
Ulysses, KS 67880-2241
Phone
(620) 356-3331
Fax
(620) 356-1932
NPI assigned
Oct 3, 2005
Organization subpart
No

Authorized official

Name
Kimberle B Doty
Title
Administrator
Phone
(620) 356-3331

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X N034001 KS Yes

Addresses

Primary practice location

510 E San Jacinto Ave
Ulysses, KS 67880-2241

Mailing address

510 E San Jacinto Ave
Ulysses, KS 67880-2241
Phone (620) 356-3331

Other identifiers

IdentifierTypeStateIssuer
100108710-BMedicaidKS

Other providers in Ulysses, KS

All providers in Ulysses, KS · Nursing Facility/Intermediate Care Facility in Kansas

Sources for this page

Verify at the official NPI Registry.