Organization
ADVANCED CARE HOME PLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEVANS ODHUNO RN (RN)
(316) 777-6477
Entity
Organization
Contact information
Practice address
5501 POLO DR, WICHITA, KS 67208-2753
(316) 777-6477
(316) 425-7898
Mailing address
5501 POLO DR, WICHITA, KS 67208-2753
(316) 777-6477
(316) 425-7898
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
B087221
KS
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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