Provider Demographics
NPI:1134347883
Name:LIGHTNING CREEK INVESTMENT GROUP INC
Entity type:Organization
Organization Name:LIGHTNING CREEK INVESTMENT GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:400 S MCGEE ST
Mailing Address - Street 2:
Mailing Address - City:CANEY
Mailing Address - State:KS
Mailing Address - Zip Code:67333-1601
Mailing Address - Country:US
Mailing Address - Phone:620-879-5199
Mailing Address - Fax:620-879-5291
Practice Address - Street 1:400 S MCGEE ST
Practice Address - Street 2:
Practice Address - City:CANEY
Practice Address - State:KS
Practice Address - Zip Code:67333-1601
Practice Address - Country:US
Practice Address - Phone:620-879-5199
Practice Address - Fax:620-879-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility