RL Maize CT 1

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

B087189 Issued in KS

Legal business name

RL MAIZE CT 1

Practice address

623 S Maize CT
Wichita, KS 67209-1337

Phone

(316) 201-6550

Fax

(316) 201-6552

NPI assigned

Nov 18, 2011

Last updated

Nov 18, 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

Susan K Engels, RN

Title

Owner/Operator

Phone

(316) 992-2119

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1851668867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 S MAIZE CT.",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672091337",
            "telephone_number": "316-201-6550",
            "fax_number": "316-201-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S MAIZE CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672091337",
            "telephone_number": "316-201-6550",
            "fax_number": "316-201-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RL MAIZE CT 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "ENGELS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "316-992-2119",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "KS",
            "license": "B087189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Dianne Rivers, RN
• Sarah A Rivers, OTR
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• Rizwan U. Hassan, M.D.
• RL Maize CT 2
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• Erica L Roach, APRN
• Patricia Ann Roach, ARNP

• Adult Care Home Facility in Wichita, KS
• Providers in Wichita, KS by specialty
• Adult Care Home Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.