Provider Demographics
NPI:1821212705
Name:HARTFORD, INC.
Entity Type:Organization
Organization Name:HARTFORD, INC.
Other - Org Name:PINE PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEP PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-284-2949
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534-0232
Mailing Address - Country:US
Mailing Address - Phone:785-284-2949
Mailing Address - Fax:
Practice Address - Street 1:211 NEOSHO ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:KS
Practice Address - Zip Code:66854-9400
Practice Address - Country:US
Practice Address - Phone:620-392-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities