Provider Demographics
NPI:1164727053
Name:SUMNER OPERATOR, LLC
Entity Type:Organization
Organization Name:SUMNER OPERATOR, LLC
Other - Org Name:WELLINGTON HEALTH AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-440-8345
Mailing Address - Street 1:1600 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-4719
Mailing Address - Country:US
Mailing Address - Phone:620-326-2232
Mailing Address - Fax:620-326-5769
Practice Address - Street 1:1600 W 8TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-4719
Practice Address - Country:US
Practice Address - Phone:620-326-2232
Practice Address - Fax:620-326-5769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200517010AMedicaid
UT175357Medicare Oscar/Certification