Provider Demographics
NPI:1205266996
Name:COLWICH GARDENS MANAGEMENT LLC
Entity type:Organization
Organization Name:COLWICH GARDENS MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-308-6670
Mailing Address - Street 1:300 E CHICAGO
Mailing Address - Street 2:
Mailing Address - City:COLWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67030-9243
Mailing Address - Country:US
Mailing Address - Phone:316-308-6670
Mailing Address - Fax:316-260-2352
Practice Address - Street 1:300 E CHICAGO
Practice Address - Street 2:
Practice Address - City:COLWICH
Practice Address - State:KS
Practice Address - Zip Code:67030-9243
Practice Address - Country:US
Practice Address - Phone:316-308-6670
Practice Address - Fax:316-260-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN087081310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility