Provider Demographics
NPI:1437197449
Name:ENTERPRISE COMMUNITY NURSING HOME INC.
Entity Type:Organization
Organization Name:ENTERPRISE COMMUNITY NURSING HOME INC.
Other - Org Name:ENTERPRISE ESTATES NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-263-8278
Mailing Address - Street 1:502 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:KS
Mailing Address - Zip Code:67441-9115
Mailing Address - Country:US
Mailing Address - Phone:785-263-8278
Mailing Address - Fax:785-263-8954
Practice Address - Street 1:502 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:KS
Practice Address - Zip Code:67441-9115
Practice Address - Country:US
Practice Address - Phone:785-263-8278
Practice Address - Fax:785-263-8954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001575OtherBCBSKS
KS001575OtherBCBSKS