KANSAS MASONIC HOME, INC. (NPI# 1841323573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841323573 |
| Entity Type | Organization |
| Organization Name | KANSAS MASONIC HOME, INC. |
| Other Organization Name | KANSAS MASONIC HOME |
| Practice Address |
401 S Seneca St Wichita KS 67213-5541 |
| Practice Telephone | 3162697500 |
| Practice Fax Number | 3162672199 |
| Mailing Telephone | 3162697500 |
| Mailing Fax Number | 3162672199 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TIM NIKKEL (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 3162697652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | N087055 | KS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 10016680B | 05 | |
| KS | STATE LICENSE | N087055 | 01 |
| Other Name | Type Code |
|---|---|
| Kansas Masonic Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952516346 | Kansas Masonic Home, Inc. | Hospice, Inpatient | 401 S Seneca St, Wichita, KS 67213-5541 | 2007-05-11 |
| Street Address |
401 S SENECA ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67213-5541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437244654 | Kansas Masonic Home | Skilled Nursing Facility | 401 S Seneca St, Wichita, KS 67213-5541 | 2006-10-04 |
| 1952516346 | Kansas Masonic Home, Inc. | Hospice, Inpatient | 401 S Seneca St, Wichita, KS 67213-5541 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689111965 | Kelsey Lynn Riefenhauser | Specialist/Technologist, Other | 3100 Mccormick, Wichita, KS 67213 | 2017-01-25 |
| 1932579513 | Gracemed Health Clinic, Inc | Clinic/Center | 755 W. Lincoln St, Wichita, KS 67213 | 2015-09-25 |
| 1134564024 | Valerie Christine Wondra | Physical Therapist | 301 S Meridian Ave, Wichita, KS 67213 | 2013-05-06 |
| 1942597505 | Carmen Maria Aguilar | Social Worker | 2312 S Meridian Ave Ste 102, Wichita, KS 67213 | 2011-07-05 |
| 1245568625 | Joanne Velez | Home Health | 711 S Main, Wichita, KS 67213 | 2009-11-24 |
| 1093958712 | Adaptive Living, LLC | Occupational Therapist | 2423 W. Maple, Ste B, Wichita, KS 67213 | 2009-04-10 |
| 1295809069 | Stacey D Langston | Technician/Technologist | 2301 S Water, Wichita, KS 67213 | 2006-11-20 |
| 1275595134 | Ronald Dean Fisher | Optometrist | 2635 W Douglas, Wichita, KS 67213 | 2006-04-05 |
| 1083676936 | Wichita Optometry, P.a. | Optometrist | 2635 W Douglas Ave, Wichita, KS 67213 | 2006-04-05 |
| 1427361385 | Ryan Carl Emrick | Optometrist | 1202 W Maple St, Wichita, KS 67213 | 2010-07-21 |
| Find all providers in zip 67213 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908091 | Agape Home Plus LLC | Assisted Living Facility | 6322 Peach Tree Ln, Wichita, KS 67218-1820 | 2020-07-02 |
| 1497255111 | Almost-home Home Plus LLC | Assisted Living Facility | 5516 Polo Dr, Wichita, KS 67208-2752 | 2018-02-19 |
| 1003321696 | Grace Cottage LLC | Assisted Living Facility | 531 N Crestline St, Wichita, KS 67212-4618 | 2017-12-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1184173304 | Fusion Senior Care Homes Plus LLC | Assisted Living Facility | 512 N Bebe St, Wichita, KS 67212-2328 | 2016-09-29 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1215302278 | Golden Boomers Home Plus LLC | Assisted Living Facility | 6953 E Kentford Cir, Wichita, KS 67226-1026 | 2015-12-02 |
| 1710226147 | Meridian West - Chaucer LLC | Assisted Living Facility | 10550 E 21st St N, Wichita, KS 67206-3509 | 2013-02-05 |
| 1922347640 | Accord Senior Care Inc. | Assisted Living Facility | 6311 E. Marjorie, Wichita, KS 67208-3629 | 2013-02-01 |
| 1932458106 | West Wichita Assisted Living, LLC | Assisted Living Facility | 629 S. Maize Ct, Wichita, KS 67209 | 2012-09-04 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.