Organization Name: | EAGLECREST LLC |
NPI Number: | 1417002429 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDA SUE O'GORMAN (EXECUTIVE DIRECTOR) |
Mailing Address: | 1501 E Magnolia Rd Salina |
State: | KS US |
Postal Code: | 674019112 |
Phone Number: | 7853091501 |
Fax Number: | 7853091502 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | N085012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |