Organization
DERBY ASSISTED LIVING, LLC
Active
Other names
Avita Senior Living at Derby
Organization subpart
No
Provider details
NPI number
Authorized official
FRED HERMES (MANAGING MEMBER)
(316) 773-1313
Entity
Organization
Contact information
Practice address
719 N. KLEIN CIRCLE, DERBY, KS 67037
(316) 260-4447
Mailing address
7200 W 13TH, SUITE 10, WICHITA, KS 67212
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
N087066
KS
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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