Provider Demographics
NPI:1801882873
Name:OSBORNE DEVELOPMENT CO., INC
Entity type:Organization
Organization Name:OSBORNE DEVELOPMENT CO., INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:YODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-842-9883
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:811 N 1ST,
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-1512
Mailing Address - Country:US
Mailing Address - Phone:785-346-2114
Mailing Address - Fax:785-346-2491
Practice Address - Street 1:811 N 1ST ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-1512
Practice Address - Country:US
Practice Address - Phone:785-346-2114
Practice Address - Fax:785-346-2491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN071002313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100109170AMedicaid
KS175409Medicare Oscar/Certification