Provider Demographics
NPI:1508123738
Name:REEDS COVE HEALTH AND REHABILITATION LLC
Entity Type:Organization
Organization Name:REEDS COVE HEALTH AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTS RECEIVABLE
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-448-0858
Mailing Address - Street 1:7200 W 13TH ST N
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2970
Mailing Address - Country:US
Mailing Address - Phone:316-773-1313
Mailing Address - Fax:316-295-4379
Practice Address - Street 1:10300 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3135
Practice Address - Country:US
Practice Address - Phone:316-448-0850
Practice Address - Fax:316-448-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175532Medicare Oscar/Certification