# GV-OP COFFEYVILLE LLC

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

## Provider details

- **NPI number:** 1982344065
- **Authorized official:** MR. SCOTT L. HINES (PRESIDENT/CEO)
- **Authorized official phone:** (620) 709-0305

## Contact information

- **Practice address:** 2904 W 8TH ST, COFFEYVILLE, KS 67337-2562
- **Practice address phone:** (620) 251-0214
- **Mailing address:** PO BOX 509, COFFEYVILLE, KS 67337-0509
- **Mailing address phone:** (620) 988-0215

## Taxonomy

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

## Other

- **Enumeration date:** 03/29/2022
- **Last updated:** 04/22/2022