Healthcare Provider Details

I. General information

NPI: 1801180831
Provider Name (Legal Business Name): ADVOCACY SERVICES OF WESTERN KANSAS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W. LINCOLN ST.
LAKIN KS
67860-9746
US

IV. Provider business mailing address

109 ALBERT ST
LAKIN KS
67860-9746
US

V. Phone/Fax

Practice location:
  • Phone: 620-355-1468
  • Fax: 620-355-1469
Mailing address:
  • Phone: 620-355-1468
  • Fax: 620-355-1469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateKS

VIII. Authorized Official

Name: WILMA LOUISE DAY
Title or Position: PRESIDENT
Credential: TCM/ KIPBS FACILITAT
Phone: 620-355-1468