17D0981081 CLIA NUMBER - BROOKDALE GREAT BEND

Laboratory Demographics

CLIA Number: 17D0981081

Facility Name: BROOKDALE GREAT BEND

Facility Address:
1206 PATTON ROAD
GREAT BEND, KS
ZIP 67530
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Facility Phone Number: 620 792-7000

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1255497871

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	17D0981081
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE GREAT BEND
Street	1206 PATTON ROAD
City	GREAT BEND
State	KS
ZIP	67530
Phone	620 792-7000
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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