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Contact Information

CLEARWATER RETIREMENT COMMUNITY INC.
620 E WOOD ST
CLEARWATER, KS67026-9757
 Phone: 620-584-2271
 Fax: 620-584-4583
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Alzheimer Center /Dementia Center/Dementia Special Care Unit

311500000X
 

Assisted Living Facility

310400000X
 

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for CLEARWATER RETIREMENT COMMUNITY INC.

NPI # 1407819246
LBN Legal business name CLEARWATER RETIREMENT COMMUNITY INC.
Authorized official IZENA MONK - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/11/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
KS License # BO87123
KS License # BO87124
KS License # NO87016
KS License # NO87053
KS Medicaid 10010890021
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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