Organization
COVENANT CARE SENIOR LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENNIS SVANDA RN (OWNER/OPERATOR)
(316) 665-9996
Entity
Organization
Contact information
Practice address
14422 E TWINLAKE DR, WICHITA, KS 67230-9517
(316) 665-9996
(316) 733-1771
Mailing address
14422 E TWINLAKE DR, WICHITA, KS 67230-9517
(316) 665-9996
(316) 733-1771
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
BO87158
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200653180A
—
KS
Enumeration date
12/03/2012
Last updated
12/03/2012
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