Provider Demographics
NPI:1326280561
Name:LINCOLN PARK MANOR INC
Entity Type:Organization
Organization Name:LINCOLN PARK MANOR INC
Other - Org Name:LINCOLN PARK MANOR HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-420-0095
Mailing Address - Street 1:113 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2803
Mailing Address - Country:US
Mailing Address - Phone:785-420-0095
Mailing Address - Fax:833-256-7073
Practice Address - Street 1:113 S 5TH ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2803
Practice Address - Country:US
Practice Address - Phone:785-420-0095
Practice Address - Fax:833-256-7073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS177274AMedicare Oscar/Certification