Provider Demographics
NPI:1467857094
Name:HCP1OC ALDERBROOK, LLC
Entity Type:Organization
Organization Name:HCP1OC ALDERBROOK, LLC
Other - Org Name:ALDERBROOK VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-789-1773
Mailing Address - Street 1:402 E WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-3894
Mailing Address - Country:US
Mailing Address - Phone:620-442-4400
Mailing Address - Fax:
Practice Address - Street 1:402 E WINDSOR RD
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-3894
Practice Address - Country:US
Practice Address - Phone:620-442-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility