Organization
TITUS BRIDGE APARTMENTS LLC
Active
Other names
Oak Creek Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN COLEMAN (PRESIDENT)
(785) 331-8782
Entity
Organization
Contact information
Practice address
3224 SW 29TH ST, TOPEKA, KS 66614-2009
(785) 272-2601
Mailing address
PO BOX 684, PERRY, KS 66073-0684
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
13-72073
KS
261QA0600X
Adult Day Care Clinic/Center
13-72073
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100388190E
KANSAS MEDICAL ASSISTANCE PROGRAM
KS
Enumeration date
04/02/2014
Last updated
04/02/2014
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