Organization
KTW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX COLE (OWNER)
(316) 683-0562
Entity
Organization
Contact information
Practice address
551 S HOLLAND ST, WICHITA, KS 67209-2007
(316) 337-5461
Mailing address
9435 E. CENTRAL, SUITE 200, WICHITA, KS 67206
(316) 683-0562
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
B087171
KS
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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