PETERSON ASSISTED LIVING LLC NPI 1003442062

NPI Information

  • NPI: 1003442062
  • Provider Name: PETERSON ASSISTED LIVING, LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 17D0972058
  • Address: 629 HOLLIDAY ST
    OSAGE CITY, KS
    ZIP 66523
  • Phone: (785) 528-3301

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NPI Details

PETERSON ASSISTED LIVING, LLC is an assisted living facility in Osage City, KS. The provider is 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. PETERSON ASSISTED LIVING, LLC NPI is 1003442062. The provider is registered as an organization entity type.

The provider's business location address is:

629 HOLLIDAY ST
OSAGE CITY, KS
ZIP 66523-137
Phone: (785) 528-3301
Fax: (785) 528-1124

The provider's authorized official is Patricia Kay Gundy .
The authorized official title is Operator/owner and has the following contact phone number (785) 528-3301.

The CLIA number assigned to this NPI record is 17D0972058 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2020 and was last updated on 3/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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