Provider Demographics
NPI:1508926312
Name:HALSTEAD HEALTH & REHAB CENTER OPERATIONS, LLC
Entity Type:Organization
Organization Name:HALSTEAD HEALTH & REHAB CENTER OPERATIONS, LLC
Other - Org Name:HALSTEAD HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-272-1535
Mailing Address - Street 1:3715 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2107
Mailing Address - Country:US
Mailing Address - Phone:785-272-1535
Mailing Address - Fax:785-440-0380
Practice Address - Street 1:915 MCNAIR ST
Practice Address - Street 2:
Practice Address - City:HALSTEAD
Practice Address - State:KS
Practice Address - Zip Code:67056-2518
Practice Address - Country:US
Practice Address - Phone:316-835-3535
Practice Address - Fax:316-835-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10010770A313M00000X
KS175446314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175446Medicare ID - Type Unspecified