Provider Demographics
NPI:1164465936
Name:ABERDEEN MEADOWS CARE CENTER, LLC
Entity Type:Organization
Organization Name:ABERDEEN MEADOWS CARE CENTER, LLC
Other - Org Name:GOLDEN KEYS NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF QUALITY ASSURANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-638-5854
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:NEODESHA
Mailing Address - State:KS
Mailing Address - Zip Code:66757-0477
Mailing Address - Country:US
Mailing Address - Phone:620-325-2639
Mailing Address - Fax:620-325-3128
Practice Address - Street 1:221 MILL ST
Practice Address - Street 2:
Practice Address - City:NEODESHA
Practice Address - State:KS
Practice Address - Zip Code:66757-1817
Practice Address - Country:US
Practice Address - Phone:620-325-2639
Practice Address - Fax:620-325-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN103001314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-5458Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION #