Organization
FSL WAYNE NE TENANT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE CRAYTON (PROJECT MANAGER)
(417) 877-1717
Entity
Organization
Contact information
Practice address
1500 VINTAGE HILL DR, WAYNE, NE 68787-1254
(402) 375-1500
Mailing address
1240 E INDEPENDENCE ST STE 200, SPRINGFIELD, MO 65804-4201
(417) 877-1717
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/01/2020
Last updated
05/13/2020
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