Healthcare Provider Details

I. General information

NPI: 1861167256
Provider Name (Legal Business Name): CLAY CENTER LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 LIBERTY ST
CLAY CENTER KS
67432-1528
US

IV. Provider business mailing address

2310 ANDERSON AVE
MANHATTAN KS
66502-2967
US

V. Phone/Fax

Practice location:
  • Phone: 785-632-5696
  • Fax:
Mailing address:
  • Phone: 785-789-4750
  • Fax: 785-789-4756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM M NOVOTNY
Title or Position: CEO
Credential:
Phone: 785-313-0946