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General NPI Number Information
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NPI Number | 1467924043
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Entity Type | Organization
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Legal Business Name | CSJI-TIFFIN INC
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 182 SAINT FRANCIS AVE
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City | TIFFIN
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State | OH
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Zip | 44883-3456
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Country | US
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Telephone | 419-447-2723
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 E LINCOLN ST
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City | WICHITA
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State | KS
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Zip | 67218-2008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT TREASURER
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Name | MR. WILLIAM JOSEPH SLATER
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Credential |
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Telephone | 316-689-4012
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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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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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