Organization
EXTRAVAGANT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PARIS COLEY (ADMINISTRATOR)
(316) 616-4508
Entity
Organization
Contact information
Practice address
4301 EAST HARRY STREET, WICHITA, KS 67218
(316) 616-4508
Mailing address
PO BOX 780898, WICHITA, KS 67278-0898
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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