Provider Demographics
NPI:1790774982
Name:VIA CHRISTI VILLAGE HAYS INC
Entity Type:Organization
Organization Name:VIA CHRISTI VILLAGE HAYS INC
Other - Org Name:ST. JOHN'S INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-628-3241
Mailing Address - Street 1:2225 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2300
Mailing Address - Country:US
Mailing Address - Phone:785-628-3241
Mailing Address - Fax:785-628-3310
Practice Address - Street 1:2401 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2345
Practice Address - Country:US
Practice Address - Phone:785-628-3241
Practice Address - Fax:785-628-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1041100601314000000X
KS2003303310A313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200330310HMedicaid
KS175498Medicare Oscar/Certification
KS175498Medicare Oscar/Certification