Healthcare Provider Details

I. General information

NPI: 1245661065
Provider Name (Legal Business Name): CRESTVIEW OPERATIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 N 8TH ST
SENECA KS
66538-1419
US

IV. Provider business mailing address

808 N 8TH ST
SENECA KS
66538-1419
US

V. Phone/Fax

Practice location:
  • Phone: 785-336-2156
  • Fax: 785-336-3881
Mailing address:
  • Phone: 785-336-2156
  • Fax: 785-336-3881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SARA M SOURK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 785-336-2156