Healthcare Provider Details

I. General information

NPI: 1275687832
Provider Name (Legal Business Name): SHELTERED LIVING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 SW HARRISON ST
TOPEKA KS
66611-2277
US

IV. Provider business mailing address

3401 SW HARRISON ST
TOPEKA KS
66611-2277
US

V. Phone/Fax

Practice location:
  • Phone: 785-233-2566
  • Fax: 785-266-8709
Mailing address:
  • Phone: 785-233-2566
  • Fax: 785-266-8709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateKS

VIII. Authorized Official

Name: KATHY BRAYTON
Title or Position: CHIEF FINANCIAL OFFI
Credential:
Phone: 785-233-2566