Provider Demographics
NPI:1003363953
Name:WELLINGTON CARE AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:WELLINGTON CARE AND REHABILITATION CENTER, LLC
Other - Org Name:BOTKIN CARE AND REHABILITATION CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-635-1195
Mailing Address - Street 1:102 W BOTKIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-2302
Mailing Address - Country:US
Mailing Address - Phone:620-326-7437
Mailing Address - Fax:620-326-7421
Practice Address - Street 1:102 W BOTKIN ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-2302
Practice Address - Country:US
Practice Address - Phone:620-326-7437
Practice Address - Fax:620-326-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA175337Medicare Oscar/Certification