Healthcare Provider Details

I. General information

NPI: 1275531295
Provider Name (Legal Business Name): DEVELOPMENTAL SERVICES OF NORTHWEST KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 HALL ST SUITE 10
HAYS KS
67601-1964
US

IV. Provider business mailing address

2703 HALL ST SUITE 10
HAYS KS
67601-1964
US

V. Phone/Fax

Practice location:
  • Phone: 785-625-5678
  • Fax: 785-625-8204
Mailing address:
  • Phone: 785-625-5678
  • Fax: 785-625-8204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. GERARD L. MICHAUD
Title or Position: PRESIDENT
Credential:
Phone: 785-625-5678