Provider Demographics
NPI:1326504028
Name:ORCHARD GARDENS, LLC
Entity Type:Organization
Organization Name:ORCHARD GARDENS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:NOVOTNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-789-4750
Mailing Address - Street 1:1213 HYLTON HEIGHTS RD STE 129
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2812
Mailing Address - Country:US
Mailing Address - Phone:785-789-4750
Mailing Address - Fax:785-789-4756
Practice Address - Street 1:1600 S WOODLAWN BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-4728
Practice Address - Country:US
Practice Address - Phone:316-691-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric