Organization
GRACIOUS SENIOR LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE BACCI (DIRECTOR OF OPERATIONS)
(316) 771-7316
Entity
Organization
Contact information
Practice address
551 S. HOLLAND, WICHITA, KS 67209
(316) 771-7316
(316) 771-7319
Mailing address
3825 E. HARRY, WICHITA, KS 67218-3722
(316) 771-7316
(316) 771-7319
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
B087171
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B087171
STATE NURSING HOME LICENSE
KS
Enumeration date
10/18/2010
Last updated
10/18/2010
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