Organization
COMMUNITY ASSISTED LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TINNEY (OWNER)
(785) 364-6128
Entity
Organization
Contact information
Practice address
806 COLORADO AVE, HOLTON, KS 66436-1329
(785) 364-6128
Mailing address
806 COLORADO AVE, HOLTON, KS 66436-1329
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200421710A
—
KS
Enumeration date
07/09/2019
Last updated
07/09/2019
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