Provider Demographics
NPI:1811554603
Name:HUT ALF LLC
Entity Type:Organization
Organization Name:HUT ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WETTIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-616-6214
Mailing Address - Street 1:8415 E 21ST ST N STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2959
Mailing Address - Country:US
Mailing Address - Phone:316-616-6288
Mailing Address - Fax:316-616-6255
Practice Address - Street 1:2416 BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-5000
Practice Address - Country:US
Practice Address - Phone:316-616-6288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA