College Hill-LTC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COLLEGE HILL-LTC LLC

Practice address

5005 East 21St Street North
Wichita, KS 67208

Phone

(678) 522-2436

NPI assigned

Dec 21, 2011

Last updated

Dec 21, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Daren Dousotn

Title

Member/Cfo

Phone

(678) 522-2436

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1184993156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 STATE BRIDGE ROAD",
            "address_2": "SUITE 401-470",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30022",
            "telephone_number": "678-522-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 EAST 21ST STREET NORTH",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67208",
            "telephone_number": "678-522-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE HILL-LTC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "DOUSOTN",
        "authorized_official_first_name": "DAREN",
        "authorized_official_title_or_position": "MEMBER/CFO",
        "authorized_official_telephone_number": "678-522-2436",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Wichita, KS
• Providers in Wichita, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.