Provider Demographics
NPI:1285629592
Name:SCHLICHT MEMORIAL LUTHERAN HOME
Entity Type:Organization
Organization Name:SCHLICHT MEMORIAL LUTHERAN HOME
Other - Org Name:DBA THE LUTHERAN HOME WAKEENEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-743-5787
Mailing Address - Street 1:320 SOUTH AVE
Mailing Address - Street 2:P.O. BOX 427
Mailing Address - City:WAKEENEY
Mailing Address - State:KS
Mailing Address - Zip Code:67672-2649
Mailing Address - Country:US
Mailing Address - Phone:785-743-5787
Mailing Address - Fax:785-743-5364
Practice Address - Street 1:320 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:WAKEENEY
Practice Address - State:KS
Practice Address - Zip Code:67672-2649
Practice Address - Country:US
Practice Address - Phone:785-743-5787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN098001313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility