Provider Demographics
NPI:1417942327
Name:MENNONITE FRIENDSHIP COMMUNITIES, INC.
Entity Type:Organization
Organization Name:MENNONITE FRIENDSHIP COMMUNITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER (CFO)
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-663-7175
Mailing Address - Street 1:600 W BLANCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67505-1526
Mailing Address - Country:US
Mailing Address - Phone:620-663-7175
Mailing Address - Fax:620-663-4221
Practice Address - Street 1:600 W BLANCHARD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67505-1526
Practice Address - Country:US
Practice Address - Phone:620-663-7175
Practice Address - Fax:620-663-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN078005314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100109420AMedicaid
KS175379Medicare Oscar/Certification