# OXFORD DERBY MEMORY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glen Carr House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346587326
- **Authorized official:** JASON WILEY (MANAGER)
- **Authorized official phone:** (316) 201-3210

## Contact information

- **Practice address:** 1433 N HAMILTON DR, DERBY, KS 67037-8919
- **Practice address phone:** (316) 788-9999
- **Mailing address:** 125 N MARKET ST, SUITE 1416, WICHITA, KS 67202-1721
- **Mailing address phone:** (316) 201-3210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | N087073 | KS | Yes |
| 311500000X | Alzheimer Center (Dementia Center) | N087078 | KS | — |

## Other

- **Enumeration date:** 01/10/2013
- **Last updated:** 01/10/2013