Provider Demographics
NPI:1245661065
Name:CRESTVIEW OPERATIONS, INC.
Entity type:Organization
Organization Name:CRESTVIEW OPERATIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOURK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-336-2156
Mailing Address - Street 1:808 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-1419
Mailing Address - Country:US
Mailing Address - Phone:785-336-2156
Mailing Address - Fax:785-336-3881
Practice Address - Street 1:808 N 8TH ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:KS
Practice Address - Zip Code:66538-1419
Practice Address - Country:US
Practice Address - Phone:785-336-2156
Practice Address - Fax:785-336-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility