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General NPI Number Information
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NPI Number | 1467857094
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Entity Type | Organization
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Legal Business Name | HCP1OC ALDERBROOK, LLC
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 402 E WINDSOR RD
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-3894
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Country | US
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Telephone | 620-442-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 402 E WINDSOR RD
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-3894
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Country | US
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Telephone | 620-442-4400
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | FRANK MARRO
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Credential |
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Telephone | 415-789-1773
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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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