Provider Demographics
NPI:1912326463
Name:WELLSPRINGS OF GARDEN PLAIN
Entity Type:Organization
Organization Name:WELLSPRINGS OF GARDEN PLAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-390-3816
Mailing Address - Street 1:6311 MARJORIE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3629
Mailing Address - Country:US
Mailing Address - Phone:316-390-3816
Mailing Address - Fax:
Practice Address - Street 1:101 W AVENUE C
Practice Address - Street 2:
Practice Address - City:GARDEN PLAIN
Practice Address - State:KS
Practice Address - Zip Code:67050-9574
Practice Address - Country:US
Practice Address - Phone:316-390-3816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home