Provider Demographics
NPI:1437550522
Name:WINFIELD LTC OPCO LLC DBA WINFIELD SENIOR LIVING COMMUNITY
Entity Type:Organization
Organization Name:WINFIELD LTC OPCO LLC DBA WINFIELD SENIOR LIVING COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIKLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-952-9216
Mailing Address - Street 1:1320 WHEAT RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-4704
Mailing Address - Country:US
Mailing Address - Phone:620-221-4660
Mailing Address - Fax:
Practice Address - Street 1:1320 WHEAT RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-4704
Practice Address - Country:US
Practice Address - Phone:620-221-4660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0140910083Medicare NSC
SD175327Medicare Oscar/Certification
KS100109000AMedicaid
KS0140910083Medicare NSC
SD175327Medicare Oscar/Certification