Provider Demographics
NPI:1750485074
Name:PRESBYTERIAN MANORS, INC.
Entity Type:Organization
Organization Name:PRESBYTERIAN MANORS, INC.
Other - Org Name:KANSAS CITY PRESBYTERIAN MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:316-685-1100
Mailing Address - Street 1:PO BOX 20440
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-1440
Mailing Address - Country:US
Mailing Address - Phone:316-685-1100
Mailing Address - Fax:316-685-2900
Practice Address - Street 1:7850 FREEMAN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2133
Practice Address - Country:US
Practice Address - Phone:913-334-3666
Practice Address - Fax:913-334-2904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN/A314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS90245014OtherBCBS KANSAS CITY
KS899973OtherBLUE CROSS
KS0963260001Medicare NSC
KS899973OtherBLUE CROSS