WEST WICHITA ASSISTED LIVING, LLC (NPI# 1932458106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932458106 |
| Entity Type | Organization |
| Organization Name | WEST WICHITA ASSISTED LIVING, LLC |
| Other Organization Name | AVITA SENIOR LIVING AT ROLLING HILLS |
| Practice Address |
629 S. Maize Ct Wichita KS 67209 |
| Mailing Address |
7200 W 13th Suite 10 Wichita KS 67212 |
| Practice Telephone | 3163612550 |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |
| Authorized Official Name | FRED HERMES (MANAGING MEMBER) |
| Authorized Official Telephone | 3167731313 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | N087067 | KS | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Avita Senior Living at Rolling Hills | Doing Business As Name - Organization |
| Street Address |
629 S. MAIZE CT |
| City | WICHITA |
| State | KS |
| Zip Code | 67209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634878 | Vonda Jeanne Foster | Pharmacist | 1402 S. Ridge Rd, Wichita, KS 67209 | 2020-09-18 |
| 1780290437 | Gaia R Priddle | Pharmacist | 1402 S Ridge Road, Wichita, KS 67209 | 2020-09-18 |
| 1134735889 | Thomas Allan Ruesch | Pharmacist | 1402 South Ridge Road, Wichita, KS 67209 | 2020-09-18 |
| 1619454337 | Zachary Hill | Pharmacist | 6110 W Kellogg, Wichita, KS 67209 | 2018-07-25 |
| 1922401785 | Jesse C Hidalgo Jr. | Hearing Instrument Specialist | 10318 W Maple St, Wichita, KS 67209 | 2014-10-07 |
| 1669782231 | Gracious Senior Living, LLC | Nursing Facility/Intermediate Care Facility | 551 S. Holland, Wichita, KS 67209 | 2010-10-18 |
| 1740598044 | Devin Jeanne Vrana | Chiropractor | 1247 S Tyler Rd, Wichita, KS 67209 | 2010-09-21 |
| 1881881019 | Jessica Harmon | Counselor | 501 S Turquoise St, Wichita, KS 67209 | 2007-10-02 |
| 1225246317 | Sullivan Gang Care Center | Technician | 6719 W. Douglas Circle, Wichita, KS 67209 | 2007-05-20 |
| 1649355975 | Eye Associates of Wichita Pa | Optometrist | 4600 W Kellogg, Suite 215, Wichita, KS 67209 | 2006-10-26 |
| Find all providers in zip 67209 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908091 | Agape Home Plus LLC | Assisted Living Facility | 6322 Peach Tree Ln, Wichita, KS 67218-1820 | 2020-07-02 |
| 1497255111 | Almost-home Home Plus LLC | Assisted Living Facility | 5516 Polo Dr, Wichita, KS 67208-2752 | 2018-02-19 |
| 1003321696 | Grace Cottage LLC | Assisted Living Facility | 531 N Crestline St, Wichita, KS 67212-4618 | 2017-12-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1184173304 | Fusion Senior Care Homes Plus LLC | Assisted Living Facility | 512 N Bebe St, Wichita, KS 67212-2328 | 2016-09-29 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1215302278 | Golden Boomers Home Plus LLC | Assisted Living Facility | 6953 E Kentford Cir, Wichita, KS 67226-1026 | 2015-12-02 |
| 1710226147 | Meridian West - Chaucer LLC | Assisted Living Facility | 10550 E 21st St N, Wichita, KS 67206-3509 | 2013-02-05 |
| 1922347640 | Accord Senior Care Inc. | Assisted Living Facility | 6311 E. Marjorie, Wichita, KS 67208-3629 | 2013-02-01 |
| 1770865321 | Lcd Unlimited, Inc | Assisted Living Facility | 1229 S. Byron Rd, Wichita, KS 67209-1811 | 2011-09-09 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.