Provider First Line Business Practice Location Address: 
2200 SW GAGE BLVD
    Provider Second Line Business Practice Location Address: 
GERIATRIC EXTENDED CARE
    Provider Business Practice Location Address City Name: 
TOPEKA
    Provider Business Practice Location Address State Name: 
KS
    Provider Business Practice Location Address Postal Code: 
66622-0001
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
785-350-3111
    Provider Business Practice Location Address Fax Number: 
785-350-4427
    Provider Enumeration Date: 
01/14/2015