Provider Demographics
NPI:1508905738
Name:KANSAS ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:KANSAS ASSISTED LIVING LLC
Other - Org Name:CARRIAGE HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:UNREIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-775-6333
Mailing Address - Street 1:723 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67054-1910
Mailing Address - Country:US
Mailing Address - Phone:316-776-2194
Mailing Address - Fax:
Practice Address - Street 1:723 S ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KS
Practice Address - Zip Code:67054-1910
Practice Address - Country:US
Practice Address - Phone:316-776-2194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN049003310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility