My Sacred Home Ii, LLC

NPI #1144457557 in Wichita, Kansas

Provider Information

NPI Number: 1144457557
Entity Type: Organization
Organization Name: My Sacred Home Ii, LLC
Primary Specialty: Specialist
Enumeration Date: Jun 12, 2009
Last Updated: Jun 12, 2009

Practice Location

Address: 7829 E ROCKHILL ST STE 406
City: Wichita
State: Kansas
ZIP Code: 67206-3915
Phone: (316) 440-4820

Authorized Official

Name: JESSICA MANZANO, MD
Title: BILLING AND CODING MANAGER
Phone: (316) 440-4820

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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