# FSL KEARNEY NE TENANT LLC

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

## Provider details

- **NPI number:** 1609497528
- **Authorized official:** LESLIE CRAYTON (PROJECT MANAGER)
- **Authorized official phone:** (417) 877-1717

## Contact information

- **Practice address:** 5410 17TH AVE, KEARNEY, NE 68845-8305
- **Practice address phone:** (308) 698-5410
- **Mailing address:** 1240 E INDEPENDENCE ST STE 200, SPRINGFIELD, MO 65804-4201
- **Mailing address phone:** (417) 877-1717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2020
- **Last updated:** 05/13/2020