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General NPI Number Information
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NPI Number | 1275536609
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Entity Type | Organization
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Legal Business Name | LAKEPOINT WICHITA, LLC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 1315 N WEST ST
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City | WICHITA
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State | KS
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Zip | 67203-1382
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Country | US
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Telephone | 316-943-1294
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Fax | 316-943-8190
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Provider Business Mailing Address
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Address Line | 1315 N WEST ST
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City | WICHITA
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State | KS
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Zip | 67203-1382
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Country | US
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Telephone | 316-943-1294
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Fax | 316-943-8190
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Authorized Official
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Title or Position | COO
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Name | MRS. CHERYL L LAVALLEE
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Credential |
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Telephone | 316-260-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | N087049
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | N087049
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License Number State | KS
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