PRISCILLA C NELSON (NPI# 1497979959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497979959 |
| Entity Type | Organization |
| Organization Name | PRISCILLA C NELSON |
| Other Organization Name | BETHEL HOUSE |
| Practice Address |
1316 N Charlotte Wichita KS 67208 |
| Mailing Address |
1842 Tara Falls Ct Wichita KS 67207-6570 |
| Practice Telephone | 3164404406 |
| Practice Fax Number | 3164404407 |
| Mailing Telephone | 3164404406 |
| Mailing Fax Number | 3162011015 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2008-07-24 |
| Authorized Official Name | MRS. PRISCILLA CHRISTINE BACCI (OWNER) |
| Authorized Official Telephone | 3163716563 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
B087145 | KS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200400780A | 05 | |
| KS | 200543750A | 05 |
| Other Name | Type Code |
|---|---|
| Bethel House | Doing Business As Name - Organization |
| Street Address |
1316 N CHARLOTTE |
| City | WICHITA |
| State | KS |
| Zip Code | 67208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316218 | Wesley Urgent Care, LLC | Clinic/Center | 2060 N. Mid Campus Dr., Wichita, KS 67208 | 2019-09-24 |
| 1023574209 | Unified Care Homes, Inc. | Custodial Care Facility | 5705 E Rockhill, Wichita, KS 67208 | 2019-02-13 |
| 1164940730 | Donita Hock | Occupational Therapy Assistant | 622 N. Edgemoor St., Wichita, KS 67208 | 2017-09-05 |
| 1427439546 | Mental Health Association of Sck | Community/Behavioral Health | 555 N Woodlawn, S 3105, Wichita, KS 67208 | 2015-06-15 |
| 1013311430 | Adrian Matta | Occupational Therapy Assistant | 1915 Farmstead Street, Wichita, KS 67208 | 2014-10-14 |
| 1700285343 | Stephanie Kendrick | Physical Therapist | 4921 E. 21st Street North, Wichita, KS 67208 | 2014-08-20 |
| 1689087942 | Apeksha Sathyaprasad | Pediatrics | 3243 E Murdock St Ste 402, Wichita, KS 67208 | 2014-06-04 |
| 1437418019 | J. W, Leisy M.d.p.a. | Psychiatry & Neurology | 3310 East Douglas #101, Wichita, KS 67208 | 2012-05-16 |
| 1184993156 | College Hill-ltc LLC | Skilled Nursing Facility | 5005 East 21st Street North, Wichita, KS 67208 | 2011-12-21 |
| 1255616132 | Thane M Vaneaton | Pharmacist | 3333 East Central, Wichita, KS 67208 | 2011-10-11 |
| Find all providers in zip 67208 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558971648 | Tracy Delois Allen | Custodial Care Facility | 2734 N Wellesley Ave, Wichita, KS 67220-2408 | 2020-08-04 |
| 1952962870 | Harmony House Home Plus LLC | Custodial Care Facility | 400 N Peterson Ave, Wichita, KS 67212-3732 | 2019-06-21 |
| 1023574209 | Unified Care Homes, Inc. | Custodial Care Facility | 5705 E Rockhill, Wichita, KS 67208 | 2019-02-13 |
| 1801322714 | Ultra Care Home Plus LLC | Custodial Care Facility | 11537 E Harry St, Wichita, KS 67207-6225 | 2017-05-11 |
| 1861932766 | Advanced Care Home Plus LLC | Custodial Care Facility | 5501 Polo Dr, Wichita, KS 67208-2753 | 2017-02-27 |
| 1477912913 | Christ Care Home Plus LLC | Custodial Care Facility | 7901 W Jennie St, Wichita, KS 67212-3537 | 2016-02-11 |
| 1457740557 | Rainbow Care Homes LLC | Custodial Care Facility | 303 N Tyler Rd, Wichita, KS 67212-3601 | 2015-01-13 |
| 1710382692 | Vista Park Senior Living | Custodial Care Facility | 1226 S Byron Rd, Wichita, KS 67209-1812 | 2014-11-04 |
| 1235541525 | Residence Begonia Home Plus LLC | Custodial Care Facility | 8327 E Zimmerly St, Wichita, KS 67207-3256 | 2014-05-21 |
| 1528488822 | Paula Denise Carter | Custodial Care Facility | 5701 E 17th St N, Wichita, KS 67208-1703 | 2014-04-24 |
| 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.