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General NPI Number Information
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NPI Number | 1023343563
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Entity Type | Organization
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Legal Business Name | FAIRVIEW ESTATES RETIREMENT COMMUNITY
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 1630 SEWELL AVE
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City | COLBY
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State | KS
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Zip | 67701
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Country | US
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Telephone | 785-462-2154
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Fax | 785-460-0226
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Provider Business Mailing Address
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Address Line | 1630 SEWELL AVE
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City | COLBY
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State | KS
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Zip | 67701-3735
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Country | US
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Telephone | 785-462-2154
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Fax | 785-460-0226
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Authorized Official
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Title or Position | OPERATOR
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Name | MR. GARY LEE STEWART
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Credential |
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Telephone | 785-462-2154
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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 | N097003
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License Number State | KS
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