Provider Demographics
NPI:1801138524
Name:COUNTY OF LANE
Entity type:Organization
Organization Name:COUNTY OF LANE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:GABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-397-5321
Mailing Address - Street 1:235 W. VINE ST.
Mailing Address - Street 2:
Mailing Address - City:DIGHTON
Mailing Address - State:KS
Mailing Address - Zip Code:67839-0001
Mailing Address - Country:US
Mailing Address - Phone:620-397-5321
Mailing Address - Fax:620-397-2823
Practice Address - Street 1:235 W. VINE ST.
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:KS
Practice Address - Zip Code:67839-0001
Practice Address - Country:US
Practice Address - Phone:620-397-5321
Practice Address - Fax:620-397-2823
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LANE/LANE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-20
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-051-001313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100106910AMedicaid