Organization
PREMIER LIVING BY WARDEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI WARDEN (OWNER/ADMINISTRATOR)
(316) 945-2028
Entity
Organization
Contact information
Practice address
234 S ANNA ST, WICHITA, KS 67209-2404
(316) 945-2028
(316) 945-0670
Mailing address
234 S ANNA ST, WICHITA, KS 67209-2404
(316) 945-2028
(316) 945-0670
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
B087119
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200975520A
—
KS
Enumeration date
03/14/2013
Last updated
03/14/2013
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