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Organization
DERBY ASSISTED LIVING, LLC
Active
Organization
DERBY ASSISTED LIVING, LLC
Active
Other names
Avita Senior Living at Derby
Organization subpart
No
Provider details
NPI number
Authorized official
FRED HERMES (MANAGING MEMBER)
(316) 773-1313
Entity
Organization
Contact information
Practice address
719 N. KLEIN CIRCLE, DERBY, KS 67037
(316) 260-4447
Mailing address
7200 W 13TH, SUITE 10, WICHITA, KS 67212
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N087066
KS
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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