Provider Demographics
NPI:1184950057
Name:RAD HOMES, LLC
Entity type:Organization
Organization Name:RAD HOMES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LARSON-FLOERSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-335-2508
Mailing Address - Street 1:308 WASHINGTON ST
Mailing Address - Street 2:PO BOX 228
Mailing Address - City:SCANDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66966-8117
Mailing Address - Country:US
Mailing Address - Phone:785-335-2508
Mailing Address - Fax:785-335-2100
Practice Address - Street 1:308 WASHINGTON ST
Practice Address - Street 2:PO B 228
Practice Address - City:SCANDIA
Practice Address - State:KS
Practice Address - Zip Code:66966-8117
Practice Address - Country:US
Practice Address - Phone:785-335-2508
Practice Address - Fax:785-335-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSB079004310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility