| NPI | 1396094470 |
|---|---|
| Doing Business As | AVITA SENIOR LIVING AT DERBY |
| Entity Type | Organization |
| Authorized Contact | FRED HERMES Managing Member 316-773-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: KS N087066) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |