Provider Demographics
NPI:1538277116
Name:LARKSFIELD PLACE RETIREMENT COMMUNITIES INC
Entity type:Organization
Organization Name:LARKSFIELD PLACE RETIREMENT COMMUNITIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HAMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-719-4748
Mailing Address - Street 1:7373 E 29TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-3405
Mailing Address - Country:US
Mailing Address - Phone:316-636-1000
Mailing Address - Fax:316-636-5790
Practice Address - Street 1:2828 N GOVERNEOUR ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1700
Practice Address - Country:US
Practice Address - Phone:316-636-1000
Practice Address - Fax:316-636-5790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN-087-031314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1042123301Medicaid
KS100111920AOtherEDS
KS175181Medicare Oscar/Certification