Basic Information
| Provider Information | |||||||||
| NPI: | 1750686531 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASHFIELD ACTIVE LIVING AND WELLNESS COMMUNITIES, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ABERDEEN HEIGHTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6525 E MAINSGATE RD | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672261062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166851100 | ||||||||
| FaxNumber: | 3166852900 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 COUCH AVE | ||||||||
| Address2: | |||||||||
| City: | KIRKWOOD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631225536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148229911 | ||||||||
| FaxNumber: | 3148219911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2011 | ||||||||
| LastUpdateDate: | 01/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | POLZIN | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | ALAN | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3148229911 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.