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General NPI Number Information
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NPI Number | 1649930256
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Entity Type | Organization
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Legal Business Name | BHAC LLC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 1316 N CHARLOTTE ST
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City | WICHITA
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State | KS
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Zip | 67208-2659
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Country | US
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Telephone | 316-440-4406
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Fax | 316-440-4407
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Provider Business Mailing Address
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Address Line | 8335 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67207-1839
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Country | US
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Telephone | 316-771-7316
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Fax | 316-364-3775
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ROXANNE FINLEY
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Credential |
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Telephone | 316-771-7316
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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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