Healthcare Provider Details

I. General information

NPI: 1700487717
Provider Name (Legal Business Name): CPF SENIOR LIVING - SEDGWICK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2455 N WOODLAWN BLVD
WICHITA KS
67220-3996
US

IV. Provider business mailing address

6900 WEDGWOOD RD N STE 300
MAPLE GROVE MN
55311-3553
US

V. Phone/Fax

Practice location:
  • Phone: 316-687-3741
  • Fax:
Mailing address:
  • Phone: 612-400-2656
  • 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: STEPHANIE SIFUENTES
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 763-544-9934