E.B. Enterprises LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

E.B. ENTERPRISES LLC

Practice address

401 N Woodlawn St
Wellington, KS 67152

Phone

(620) 326-2030

NPI assigned

Jun 21, 2017

Organization subpart

No

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

Authorized official

Name

Julianne Brizendine

Title

Operator

Phone

(806) 662-3839

Specialties & licenses 1

Addresses

Other names 1

• Serenity Senior Retreat Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Irvin Roy Penner, LSCSW MSW

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1568559391
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1356861355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N WOODLAWN ST",
            "city": "WELLINGTON",
            "state": "KS",
            "postal_code": "671522857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N WOODLAWN ST",
            "city": "WELLINGTON",
            "state": "KS",
            "postal_code": "67152",
            "telephone_number": "620-326-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.B. ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "BRIZENDINE",
        "authorized_official_first_name": "JULIANNE",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "806-662-3839"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Senior Retreat",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Senior Retreat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annette Michelle Daniels, P.A.-C
• Deseret Health Group
• Deseret Nursing and Rehabilitation at Wellington
• Dillon Companies LLC
• Patricia Dudley-Gangwere, LCPC
• Katherine Lee Eck
• Erickson & Gill, P.a.
• Erickson & Gill, P.a.
• Channity M Farley, APRN
• Tasia K Farley, LMLP

• Assisted Living Facility in Wellington, KS
• Providers in Wellington, KS by specialty
• Assisted Living Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.