Provider Demographics
NPI:1649511676
Name:OXFORD WICHITA HOMES PLUS, LLC
Entity type:Organization
Organization Name:OXFORD WICHITA HOMES PLUS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-201-3210
Mailing Address - Street 1:125 N MARKET ST
Mailing Address - Street 2:SUITE 1416
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1721
Mailing Address - Country:US
Mailing Address - Phone:316-201-3210
Mailing Address - Fax:316-201-3219
Practice Address - Street 1:2119 N BROADMOOR ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1028
Practice Address - Country:US
Practice Address - Phone:316-201-3210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSB087182310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility