Healthcare Provider Details

I. General information

NPI: 1902571862
Provider Name (Legal Business Name): OXFORD MADISON HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 N 1ST ST
NORFOLK NE
68701-0904
US

IV. Provider business mailing address

125 N MARKET ST STE 1230
WICHITA KS
67202-1712
US

V. Phone/Fax

Practice location:
  • Phone: 402-644-4567
  • Fax:
Mailing address:
  • Phone: 316-201-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: IRIS TURNER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 316-201-3210