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General NPI Number Information
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NPI Number | 1255723524
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Entity Type | Organization
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Legal Business Name | AHG SHAWNEE, LLC
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 16207 MIDLAND DR
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City | SHAWNEE
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State | KS
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Zip | 66217-9499
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Country | US
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Telephone | 913-345-1032
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Fax | 913-345-1044
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Provider Business Mailing Address
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Address Line | 11701 NIEMAN RD
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City | OVERLAND PARK
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State | KS
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Zip | 66210-4310
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Country | US
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Telephone | 913-345-1032
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Fax | 913-345-1044
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Authorized Official
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Title or Position | CEO
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Name | MR. NORMAN G WILCOX
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Credential |
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Telephone | 913-345-1032
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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 | KS
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