# COLLEGE HILL-LTC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184993156
- **Authorized official:** MR. DAREN DOUSOTN (MEMBER/CFO)
- **Authorized official phone:** (678) 522-2436

## Contact information

- **Practice address:** 5005 EAST 21ST STREET NORTH, WICHITA, KS 67208
- **Practice address phone:** (678) 522-2436
- **Mailing address:** 10945 STATE BRIDGE ROAD, SUITE 401-470, ALPHARETTA, GA 30022
- **Mailing address phone:** (678) 522-2436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 12/21/2011
- **Last updated:** 12/21/2011