Healthcare Provider Details

I. General information

NPI: 1497749774
Provider Name (Legal Business Name): COUNTY OF MITCHELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 W 8TH ST
BELOIT KS
67420-1603
US

IV. Provider business mailing address

310 W 8TH ST
BELOIT KS
67420-1603
US

V. Phone/Fax

Practice location:
  • Phone: 785-738-5175
  • Fax: 785-738-5053
Mailing address:
  • Phone: 785-738-5175
  • Fax: 785-738-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA-062-001
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA A DOWLIN
Title or Position: ADMINISTRATOR
Credential: B.S.N., R.N.
Phone: 785-738-5175