VINTAGE PARK AT GARDNER LLC NPI 1548226475

NPI Information

  • NPI: 1548226475
  • Provider Name: VINTAGE PARK AT GARDNER LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 17D0978758
  • Address: 869 JUNIPER TERRACE
    GARDNER, KS
    ZIP 66030
  • Phone: (913) 884-8900

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NPI Details

VINTAGE PARK AT GARDNER LLC is an assisted living facility in Gardner, 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. VINTAGE PARK AT GARDNER LLC NPI is 1548226475. The provider is registered as an organization entity type.

The provider's business location address is:

869 JUNIPER TERRACE
GARDNER, KS
ZIP 66030
Phone: (913) 884-8900
Fax: (913) 884-4582

The provider's authorized official is Eddie Parades .
The authorized official title is Sr Vice President Of Operations and has the following contact phone number (210) 493-3165.

The CLIA number assigned to this NPI record is 17D0978758 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/20/2006 and was last updated on 8/22/2020.

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 FacilityN046055KANSASYes

What is NPI?

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

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