# LAKEWOOD SENIOR LIVING OF SEVILLE LLC

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

## Provider details

- **NPI number:** 1639244536
- **Authorized official:** TOM KENT (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (205) 320-7554

## Contact information

- **Practice address:** 1319 SEVILLE ST, WICHITA, KS 67209-1828
- **Practice address phone:** (316) 722-5641
- **Mailing address:** 3008 7TH AVE S, BIRMINGHAM, AL 35233-3503

## Taxonomy

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

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100001100125 | — | KS |