STANLEY R KJELLBERG (NPI# 1790095438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790095438 |
| Entity Type | Individual |
| Full Name | STANLEY R KJELLBERG |
| Credential | COTA/L |
| Practice Address |
1909 Landon Street Hutchinson KS 67502 |
| Practice Telephone | 6206653853 |
| Mailing Telephone | 6206653853 |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
18-00247 | KS | Nursing & Custodial Care Facilities |
| Street Address |
1909 LANDON STREET |
| City | HUTCHINSON |
| State | KS |
| Zip Code | 67502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770032054 | Maryann M Hawkinson | Nurse Practitioner | 2700 E 30th, Hutchinson, KS 67502 | 2016-09-27 |
| 1801257415 | Kenneth Lee Herdt | Hearing Instrument Specialist | 210 E 30th Ave Ste 112, Hutchinson, KS 67502 | 2016-03-09 |
| 1588072052 | Kim Swafford | Pharmacist | 1791 E 23rd, Hutchinson, KS 67502 | 2014-07-29 |
| 1366752164 | Andrea L Bribiesca | Case Manager/Care Coordinator | 14 17th Crestview, Hutchinson, KS 67502 | 2010-10-14 |
| 1649592569 | Christopher Lee Bailey | Pharmacist | 1320 E. 30th Ave, Hutchinson, KS 67502 | 2010-02-19 |
| 1245464619 | Travis L Gillespie | Dentist | 200 E 30th Ave Ste A, Hutchinson, KS 67502 | 2009-05-13 |
| 1659522548 | Owens Optical | Eyewear Supplier (Equipment, not the service) | 522 -e- 30th, Hutchinson, KS 67502 | 2008-10-09 |
| 1386848026 | Ruth Elaine Buell | Occupational Therapist | 1202 East 23rd St., Hutchinson, KS 67502 | 2007-06-14 |
| 1326260308 | Darron D. Veh | Physical Therapist | 2500 E. 30th, Hutchinson, KS 67502 | 2007-05-02 |
| 1851512099 | Emeritus Corporation | Alzheimer Center (Dementia Center) | 2416 Brentwood, Hutchinson, KS 67502 | 2007-05-02 |
| Find all providers in zip 67502 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| City | HUTCHINSON |
| Zip Code | 67502 |
Please comment or provide details below to improve the information on STANLEY R KJELLBERG.
| 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.