Provider Demographics
NPI:1770636656
Name:ST. JOHNS, INC.
Entity Type:Organization
Organization Name:ST. JOHNS, INC.
Other - Org Name:ST. JOHN'S VICTORIA
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-946-5215
Mailing Address - Street 1:701 7TH ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:KS
Mailing Address - Zip Code:67671-9527
Mailing Address - Country:US
Mailing Address - Phone:785-735-2208
Mailing Address - Fax:785-735-2270
Practice Address - Street 1:701 7TH ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:KS
Practice Address - Zip Code:67671-9527
Practice Address - Country:US
Practice Address - Phone:785-735-2208
Practice Address - Fax:785-735-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN026004313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17E200OtherFEDERAL PROVIDER NUMBER