Organization Name: | MEMORIAL HOME, INC. |
NPI Number: | 1801896782 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON T STUCKY (CFO) |
Mailing Address: | 86 22nd Ave Moundridge |
State: | KS US |
Postal Code: | 671077003 |
Phone Number: | 6203452901 |
Fax Number: | 6203452937 |
NPI Enumeration Date: | 07/21/2005 |
NPI Last Update Date: | 01/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3140N1450X |
License Number: | N059002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Skilled Nursing Facility |
Taxonomy Specialization: | Nursing Care, Pediatric |
Taxonomy Definition: | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |