Provider Demographics
NPI:1336585611
Name:GREENWOOD SKILLED NURSING AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:GREENWOOD SKILLED NURSING AND REHABILITATION CENTER LLC
Other - Org Name:NOTTINGHAM HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTS RECEIVABLE
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-448-0858
Mailing Address - Street 1:14200 W 134TH PL
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6140
Mailing Address - Country:US
Mailing Address - Phone:913-738-8306
Mailing Address - Fax:
Practice Address - Street 1:14200 W 134TH PL
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6140
Practice Address - Country:US
Practice Address - Phone:316-448-0858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201092130AMedicaid
KS201092130AMedicaid