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General NPI Number Information
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NPI Number | 1437755766
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Entity Type | Organization
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Legal Business Name | COLWICH GARDENS ASSISTED LIVING LLC
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 300 E CHICAGO AVE
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City | COLWICH
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State | KS
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Zip | 67030-9243
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Country | US
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Telephone | 316-260-1034
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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 | 316-448-0850
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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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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