Organization
LAKEWOOD SENIOR LIVING OF SEVILLE, LLC
Active
Other names
Lakewood Senior Living of Seville
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. APRIL M PUCCETTI NHA (VICE PRESIDENT OF OPERATIONS)
(205) 320-7507
Entity
Organization
Contact information
Practice address
1319 SEVILLE ST., WICHITA, KS 67209-1828
(316) 722-6916
(317) 722-5641
Mailing address
1319 SEVILLE ST., WICHITA, KS 67209-1828
(316) 722-6916
(316) 722-5641
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N087010
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100109700A
—
KS
05
—
200573270A
—
KS
Enumeration date
06/03/2006
Last updated
05/11/2010
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