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General NPI Number Information
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NPI Number | 1245193242
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Entity Type | Organization
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Legal Business Name | WATSON VILLAGE LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 6520 E FARMVIEW ST
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City | WICHITA
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State | KS
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Zip | 67206-1007
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Country | US
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Telephone | 316-747-4960
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Fax | 316-747-4967
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Provider Business Mailing Address
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Address Line | 6520 E FARMVIEW ST
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City | WICHITA
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State | KS
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Zip | 67206-1007
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Country | US
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Telephone | 316-747-4960
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Fax | 316-747-4967
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Authorized Official
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Title or Position | OPERATOR
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Name | MS. BREAUNA DSHON TROTTER
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Credential | AO
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Telephone | 316-747-4960
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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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