# LAKEWOOD SENIOR LIVING OF SEVILLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakewood Senior Living of Seville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205874997
- **Authorized official:** MRS. APRIL M PUCCETTI NHA (VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (205) 320-7507

## Contact information

- **Practice address:** 1319 SEVILLE ST., WICHITA, KS 67209-1828
- **Practice address phone:** (316) 722-6916
- **Practice address fax:** (317) 722-5641
- **Mailing address:** 1319 SEVILLE ST., WICHITA, KS 67209-1828
- **Mailing address phone:** (316) 722-6916
- **Mailing address fax:** (316) 722-5641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N087010 | KS | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 05/11/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100109700A | — | KS |
| 05 | — | 200573270A | — | KS |