Healthcare Provider Details

I. General information

NPI: 1437204989
Provider Name (Legal Business Name): KARIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E FULTON TER
GARDEN CITY KS
67846-6165
US

IV. Provider business mailing address

1515 E FULTON TER
GARDEN CITY KS
67846-6165
US

V. Phone/Fax

Practice location:
  • Phone: 620-260-9931
  • Fax: 620-260-9933
Mailing address:
  • Phone: 620-260-9931
  • Fax: 620-260-9933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateKS

VIII. Authorized Official

Name: CHERYL E STURDEVANT
Title or Position: SECRETARY TREASURER
Credential:
Phone: 620-260-9931