Provider Demographics
NPI:1538293816
Name:LIGHTING CREEK INVESTMENT GROUP INC
Entity Type:Organization
Organization Name:LIGHTING CREEK INVESTMENT GROUP INC
Other - Org Name:GUEST HOME ESTATES VII
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:RAYNE
Authorized Official - Last Name:MADDUX
Authorized Official - Suffix:
Authorized Official - Credentials:BS - BUS ADMIN
Authorized Official - Phone:918-273-3649
Mailing Address - Street 1:806 W 4TH
Mailing Address - Street 2:GUEST HOME ESTATES VII
Mailing Address - City:GARNETT
Mailing Address - State:KS
Mailing Address - Zip Code:66032
Mailing Address - Country:US
Mailing Address - Phone:785-448-6884
Mailing Address - Fax:785-448-3377
Practice Address - Street 1:806 W 4TH
Practice Address - Street 2:GUEST HOME ESTATES VII
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032
Practice Address - Country:US
Practice Address - Phone:785-448-6884
Practice Address - Fax:785-448-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS310400000X310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility