Provider Demographics
NPI:1457650509
Name:SEVILLE OPERATOR, LLC
Entity Type:Organization
Organization Name:SEVILLE OPERATOR, LLC
Other - Org Name:ROLLING HILLS HEALTH AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-440-8345
Mailing Address - Street 1:1319 SEVILLE STREET
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:66783-1640
Mailing Address - Country:US
Mailing Address - Phone:316-722-6916
Mailing Address - Fax:316-722-5641
Practice Address - Street 1:1319 SEVILLE STREET
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:66783-1640
Practice Address - Country:US
Practice Address - Phone:316-722-6916
Practice Address - Fax:316-722-5641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200722780AMedicaid
KS175253Medicare Oscar/Certification