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General NPI Number Information
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NPI Number | 1851715510
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Entity Type | Organization
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Legal Business Name | NDJJ CORP
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 02/14/2014
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Provider Practice Location Address
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Address Line | 6403 E MARJORE
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City | WICHITA
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State | KS
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Zip | 67206
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Country | US
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Telephone | 316-253-5788
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Fax | 316-201-6372
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Provider Business Mailing Address
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Address Line | 6403 E MARJORIE ST
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City | WICHITA
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State | KS
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Zip | 67206-1421
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Country | US
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Telephone | 316-253-5788
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Fax | 316-201-6372
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | NICHOLE MARIE SEILER
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Credential |
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Telephone | 316-253-5788
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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 | B087202
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License Number State | KS
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