| NPI | 1912195249 |
|---|---|
| Doing Business As | FIFTH AVENUE PLACE |
| Entity Type | Organization |
| Authorized Contact | BRENDA S SHERWOOD CEO/President 785-284-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2011-12-15 |