Healthcare Provider Details

I. General information

NPI: 1144057001
Provider Name (Legal Business Name): OXFORD VISTA SENIOR LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S MARTINSON ST
WICHITA KS
67213
US

IV. Provider business mailing address

402 S MARTINSON ST
WICHITA KS
67213
US

V. Phone/Fax

Practice location:
  • Phone: 316-613-3570
  • Fax:
Mailing address:
  • Phone: 316-613-3570
  • 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: CHARLOTTE CLAAR
Title or Position: EXECUTIVE DIRECTOR
Credential: LNHA
Phone: 316-613-3570