MEDICARE: THE MEADOWS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	B087192	KS

General Provider Information

NPI Number	:	1205191178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MEADOWS

Provider Business Mailing Address
First Line	:	15 CRESTVIEW LAKES EST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-2913
Country	:	US
Telephone Number	:	316-295-2760
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 CRESTVIEW LAKES EST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-2913
Country	:	US
Telephone Number	:	316-295-2760
Fax Number	:

Authorized Official
Title or Position	:	ARNP/OPERATOR/OWNER
Name	:	VEOMANY DANG
Credential	:
Telephone Number	:	316-650-7620

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	07/06/2012

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Directions to “THE MEADOWS ” Practice Location

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