Provider Demographics
NPI:1447255633
Name:MENNONITE BOARD OF MISSIONS AND CHARITIES OF KANSAS INC
Entity type:Organization
Organization Name:MENNONITE BOARD OF MISSIONS AND CHARITIES OF KANSAS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KREHBIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-327-4261
Mailing Address - Street 1:200 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-8100
Mailing Address - Country:US
Mailing Address - Phone:620-327-4261
Mailing Address - Fax:620-327-4262
Practice Address - Street 1:200 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-8100
Practice Address - Country:US
Practice Address - Phone:620-327-4261
Practice Address - Fax:620-327-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN040006314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100109040AMedicaid
KS1270OtherBCBS OF KS
KS175386Medicare Oscar/Certification