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General NPI Number Information
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NPI Number | 1386479053
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Entity Type | Organization
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Legal Business Name | VILLA HEIGHTS LIVING LLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 816 S MULBERRY ST
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City | GARDNER
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State | KS
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Zip | 66030-9248
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Country | US
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Telephone | 913-645-9151
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Fax | 913-605-1096
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Provider Business Mailing Address
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Address Line | 816 S MULBERRY ST
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City | GARDNER
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State | KS
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Zip | 66030-9248
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Country | US
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Telephone | 913-645-9151
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Fax | 913-605-1096
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DEBRA ANJELA OLIMA
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Credential |
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Telephone | 913-645-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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