Provider Demographics
NPI:1629068838
Name:KIDRON BETHEL RETIREMENT SERVICES, INC.
Entity Type:Organization
Organization Name:KIDRON BETHEL RETIREMENT SERVICES, INC.
Other - Org Name:BETHEL HEALTHCARE CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KREHBIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-284-2900
Mailing Address - Street 1:3001 IVY DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67117-8002
Mailing Address - Country:US
Mailing Address - Phone:316-284-2900
Mailing Address - Fax:316-284-0173
Practice Address - Street 1:3001 IVY DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67117-8002
Practice Address - Country:US
Practice Address - Phone:316-284-2900
Practice Address - Fax:316-284-0173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
KSN040-001314000000X
KSN-040-001314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100107280BOtherHCBS
KS100107280AMedicaid
KS10010728BOtherHCBS-KS
KS10010728BOtherHCBS-KS