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General NPI Number Information
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NPI Number | 1063339836
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Entity Type | Organization
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Legal Business Name | GEORGETOWN BY AXIOM LLC
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 1655 S GEORGETOWN ST
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City | WICHITA
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State | KS
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Zip | 67218-4111
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Country | US
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Telephone | 316-685-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 W MAPLE ST
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City | WICHITA
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State | KS
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Zip | 67209-3135
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Country | US
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Telephone | 316-500-7930
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRENDA KRUSE
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Credential |
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Telephone | 316-500-7930
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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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