Healthcare Provider Details

I. General information

NPI: 1457477812
Provider Name (Legal Business Name): LIGHTNIG GREEK INVESTMENT GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 220TH RD
CHANUTE KS
66720-6409
US

IV. Provider business mailing address

7440 220TH RD
CHANUTE KS
66720-6409
US

V. Phone/Fax

Practice location:
  • Phone: 620-431-7115
  • Fax:
Mailing address:
  • Phone: 620-431-7115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberN067008
License Number StateKS

VIII. Authorized Official

Name: MRS. KATHRYN RAYNE MADDUX
Title or Position: OFFICE MGR.
Credential:
Phone: 918-273-3649