Provider Demographics
NPI:1871085894
Name:MCCALL MANOR OPERATING CO LLC
Entity type:Organization
Organization Name:MCCALL MANOR OPERATING CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-825-8183
Mailing Address - Street 1:626 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4105
Mailing Address - Country:US
Mailing Address - Phone:785-825-8183
Mailing Address - Fax:785-825-1608
Practice Address - Street 1:626 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4105
Practice Address - Country:US
Practice Address - Phone:785-825-8183
Practice Address - Fax:785-825-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSB085009253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care