Healthcare Provider Details

I. General information

NPI: 1477521151
Provider Name (Legal Business Name): DEVELOPMENTAL SERVICES OF NORTHWEST KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 HALL ST SUITE 10
HAYS KS
67601-1964
US

IV. Provider business mailing address

PO BOX 310
HAYS KS
67601-0310
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 TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

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