17D0955558 CLIA NUMBER - VINTAGE PARK AT WAMEGO

Laboratory Demographics

CLIA Number: 17D0955558

Facility Name: VINTAGE PARK AT WAMEGO

Facility Address:
1607 FOURTH STREET
WAMEGO, KS
ZIP 66547
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Facility Phone Number: 785 456-8997

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1891150439

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	17D0955558
LAB Type	Assisted Living Facility
Facility Name	VINTAGE PARK AT WAMEGO
Street	1607 FOURTH STREET
City	WAMEGO
State	KS
ZIP	66547
Phone	785 456-8997
CertificateType	4
CertificateEffectiveDate	1/4/2023
CertificateExpirationDate	1/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024