Healthcare Provider Details

I. General information

NPI: 1538524178
Provider Name (Legal Business Name): CPF SENIOR LIVING - EUREKA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 E RIVER ST
EUREKA KS
67045-2156
US

IV. Provider business mailing address

980 N MICHIGAN AVE SUITE 1998
CHICAGO IL
60611-4501
US

V. Phone/Fax

Practice location:
  • Phone: 620-583-7473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JAY FLATT
Title or Position: CFO
Credential:
Phone: 312-273-4750