Provider Demographics
NPI:1023429727
Name:RUSH COUNTY NURSING HOME SOCIETY
Entity type:Organization
Organization Name:RUSH COUNTY NURSING HOME SOCIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RATHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-222-2574
Mailing Address - Street 1:701 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:KS
Mailing Address - Zip Code:67548-9738
Mailing Address - Country:US
Mailing Address - Phone:785-222-2574
Mailing Address - Fax:785-222-9034
Practice Address - Street 1:701 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:KS
Practice Address - Zip Code:67548-9738
Practice Address - Country:US
Practice Address - Phone:785-222-2574
Practice Address - Fax:785-222-9034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251E00000X
KS100109770C253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100109770AMedicaid
KS175369Medicare Oscar/Certification