1770865321 NPI number — LCD UNLIMITED, INC

Table of content: (NPI 1770865321)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770865321 NPI number — LCD UNLIMITED, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LCD UNLIMITED, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CARING HEARTS FOR SENIOR LIVING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770865321
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11509 W. BURTON
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67209-4049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-721-4803
Provider Business Mailing Address Fax Number:
316-773-2492

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1229 S. BYRON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67209-1811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-773-9726
Provider Business Practice Location Address Fax Number:
316-773-2492
Provider Enumeration Date:
09/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DIERKS
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
LORANE
Authorized Official Title or Position:
PRESIDENT/OPERATOR
Authorized Official Telephone Number:
316-993-8942

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com