Country Club Estates LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COUNTRY CLUB ESTATES LP

Practice address

2 Lewis Dr
Paola, KS 66071-1126

Phone

(913) 294-4531

Fax

(913) 294-6969

NPI assigned

Apr 26, 2007

Last updated

Aug 22, 2020By 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. David E Achey

Title

Owner

Phone

(913) 294-4531

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861612376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LEWIS DR",
            "city": "PAOLA",
            "state": "KS",
            "postal_code": "660711126",
            "telephone_number": "913-294-4531",
            "fax_number": "913-294-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LEWIS DR",
            "city": "PAOLA",
            "state": "KS",
            "postal_code": "660711126",
            "telephone_number": "913-294-4531",
            "fax_number": "913-294-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CLUB ESTATES LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ACHEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-294-4531",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.