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General NPI Number Information
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NPI Number | 1003518291
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Entity Type | Organization
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Legal Business Name | BLASI MANAGEMENT LLC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 619 S MAIZE CT
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City | WICHITA
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State | KS
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Zip | 67209-1337
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Country | US
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Telephone | 316-308-3921
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 E SUNSET ST
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City | GODDARD
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State | KS
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Zip | 67052-8610
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Country | US
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Telephone | 316-308-3921
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | HAYLEY ELIZABETH BETTE
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Credential | RN
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Telephone | 316-308-3921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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