COUNTRYSIDE HOME (NPI# 1598893869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598893869 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE HOME |
| Practice Address |
122 S Countryside Ln Wellington KS 67152-8077 |
| Practice Telephone | 6203268749 |
| Practice Fax Number | 6203262254 |
| Mailing Telephone | 6203268749 |
| Mailing Fax Number | 6203262254 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2008-07-14 |
| Authorized Official Name | MRS. CHANNITY MARIE FARLEY (OWNER OPERATOR) |
| Authorized Official Telephone | 6203268749 |
| Authorized Official Credential | REGISTEREDNURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
B096014 | KS | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902881022 | Countryside Home | Skilled Nursing Facility | 703 N Main St, Madison, NE 68748-6009 | 2005-12-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | COUNTRYSIDE HOME BUILDERS , INC. | 11 Draper Woods Rd., Fiskdale, MA 01518 |
| Iowa Business Entities | COUNTRYSIDE HOME BUILDERS, INC. | P.o. Box 1782, Council Bluffs, IA 51502 |
| Oregon Corporations, Companies and Business Names | COUNTRYSIDE HOME CARE | 3275 Snowy Butte Ln, Central Point, OR 97502 |
| Oregon Corporations, Companies and Business Names | COUNTRYSIDE HOME CARE II | 3243 Snowy Butte Ln, Central Point, OR 97502 |
| Oregon Corporations, Companies and Business Names | COUNTRYSIDE HOME CARE III | 271 Black Oak Dr, Medford, OR 97504 |
| Indiana Business Entities | COUNTRYSIDE HOME IMPROVEMENTS CO. | 5864 E Sr 236, Rockville, IN 47872 |
| Virginia Business Entities | Countryside Homecrafters LC | 9 S Augusta St, Po Box 2366, Staunton, Virginia 24402-2366 |
| Virginia Business Entities | Countryside Homeowners Association Inc. | 8721 Ruggles Rd, Henrico, Virginia 23229-7941 |
| Colorado Business Entities | COUNTRYSIDE HOMEOWNERS' ASSOCIATION, A COLORADO NON-PROFITCORPORATION, C.S.P. | 2619 Canton Court, Suite A, Fort Collins, CO 80525 |
| Vermont Business Registrations | COUNTRYSIDE HOMEOWNERS' ASSOCIATION, INC. THE | 4 Spruce Lane, Essex Junction, VT 05453 |
| Street Address |
122 S COUNTRYSIDE LN |
| City | WELLINGTON |
| State | KS |
| Zip Code | 67152-8077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417373556 | Khan Noohani Md Pa | Psychiatric Unit | 1323 North A Street, Sumner Regional Medical Center, Wellington, KS 67152 | 2014-03-13 |
| 1114266293 | Symmetris, P.a. | Dentist | 122 E. Lincoln, Wellington, KS 67152 | 2013-02-08 |
| 1851485502 | Wellington Family Dentistry | Dentist | 119 East Lincoln, Wellington, KS 67152 | 2006-10-03 |
| 1073553871 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 1111 W 8th St, Wellington, KS 67152 | 2006-06-08 |
| 1629071816 | City of Wellington | Emergency Medical Technician, Basic | 200 North C Street, Suite 200, Wellington, KS 67152 | 2005-05-23 |
| 1356861355 | E.b. Enterprises LLC | Assisted Living Facility | 401 N Woodlawn St, Wellington, KS 67152 | 2017-06-21 |
| 1184753113 | Angela L Baker | Social Worker | 1601 W 16th St, Wellington, KS 67152 | 2007-03-05 |
| 1275619504 | Sumner Mental Health Center | Counselor | 1601 West 16th Street, Wellington, KS 67152 | 2006-10-30 |
| 1629352877 | Cherished Friends LLC | Assisted Living Facility | 924 S Washington Ave, Wellington, KS 67152-2201 | 2011-10-06 |
| 1427009612 | Ggnsc Wellington LLC | Skilled Nursing Facility | 102 W Botkin St, Wellington, KS 67152-2302 | 2006-05-13 |
| Find all providers in zip 67152 | ||||
| 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 |
| 1043841174 | Selah Home LLC | Custodial Care Facility | 15834 Sw Butler Rd, Rose Hill, KS 67133-8549 | 2020-01-28 |
| 1881238681 | Goshen Home Care Inc. | Custodial Care Facility | 9939 Foster St, Overland Park, KS 66212-2452 | 2019-11-05 |
| 1952962870 | Harmony House Home Plus LLC | Custodial Care Facility | 400 N Peterson Ave, Wichita, KS 67212-3732 | 2019-06-21 |
| 1508329905 | Karaway LLC | Custodial Care Facility | 1815 Sw Westwood Cir, Topeka, KS 66604-3269 | 2019-04-11 |
| 1023574209 | Unified Care Homes, Inc. | Custodial Care Facility | 5705 E Rockhill, Wichita, KS 67208 | 2019-02-13 |
| 1881175966 | Rl Fountainwood 2 | Custodial Care Facility | 2000 Fountainwood, Hutchinson, KS 67502-2662 | 2018-08-27 |
| 1306335328 | Anthem Overland Park Management, LLC | Custodial Care Facility | 6921 W 81st St, Overland Park, KS 66204-3913 | 2018-05-04 |
| 1518470186 | Rl Dodge City 1 | Custodial Care Facility | 2800 6th Ave, Dodge City, KS 67801-2478 | 2017-11-06 |
| 1801322714 | Ultra Care Home Plus LLC | Custodial Care Facility | 11537 E Harry St, Wichita, KS 67207-6225 | 2017-05-11 |
| Find all providers with the same taxonomy | ||||
| City | WELLINGTON |
| Zip Code | 67152 |
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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.