MEDICARE: HOMESTEAD OF CRESTVIEW OPERATIONS LLC

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	310400000X	Assisted Living Facility	N087059	KS

General Provider Information

NPI Number	:	1811342280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMESTEAD OF CRESTVIEW OPERATIONS LLC

Provider Business Mailing Address
First Line	:	3715 SW 29TH ST
Second Line	:	SUITE 200
City	:	TOPEKA
State	:	KS
Zip	:	66614-2107
Country	:	US
Telephone Number	:	785-272-1535
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N 127TH ST E
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2807
Country	:	US
Telephone Number	:	316-733-8100
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL D TRYON
Credential	:
Telephone Number	:	785-272-1535

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	05/04/2016

Similar Medicare Providers

1023296860 — COURTNEY RENAY RUIZ COTA
Practice Location Address:

4507 LAKE PARK DR
WICHITA FALLS, TX
76302-2807

Practice Phone: 936-332-5298
Practice Fax:

1619858479 — KYLE HADEN ATC
Practice Location Address:

7627 E 37TH ST N APT 2403
WICHITA, KS
67226-2807

Practice Phone: 785-614-4410
Practice Fax:

1932861846 — JEREMIAH COON
Practice Location Address:

8080 E CENTRAL AVE STE 190
WICHITA, KS
67206-2389

Practice Phone: 316-260-3777
Practice Fax:

1114019254 — LUXOTTICA OF AMERICA INC.
Practice Location Address:

2122 N ROCK RD STE O-710
WICHITA, KS
67206-1273

Practice Phone: 316-682-0583
Practice Fax:

1881559672 — SAMANTHA ROSE COUNSELING
Practice Location Address:

250 N ROCK RD STE 130
WICHITA, KS
67206-2261

Practice Phone: 316-229-4340
Practice Fax:

1225863889 — REGINA REANN TEER
Practice Location Address:

6611 E CENTRAL AVE STE C
WICHITA, KS
67206-1937

Practice Phone: 316-640-8197
Practice Fax:

Directions to “HOMESTEAD OF CRESTVIEW OPERATIONS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.