Healthcare Provider Details
I. General information
NPI: 1700025640
Provider Name (Legal Business Name): ADVOCACY FIRST
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/17/2009
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
320 EMERSON AVE
BONNER SPRINGS KS
66012-1118
US
IV. Provider business mailing address
PO BOX 305
BONNER SPRINGS KS
66012-0300
US
V. Phone/Fax
- Phone: 913-961-6563
- Fax: 913-441-1009
- Phone: 913-961-6563
- Fax: 913-441-1009
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | KS |
VIII. Authorized Official
Name: MRS.
TAMERA
LYNN
PAINE
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 913-961-6563