Organization
WABASH BICKFORD COTTAGE OPCO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. A FAIRBANKS (EXECUTIVE VP)
(913) 782-3200
Entity
Organization
Contact information
Practice address
3037 W DIVISION RD, WABASH, IN 46992-8477
(260) 569-2000
(260) 569-6759
Mailing address
13795 S MUR LEN RD, SUITE 301, OLATHE, KS 66062-1675
(913) 782-3200
(913) 782-4851
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
17-003466-1
IN
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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