Healthcare Provider Details

I. General information

NPI: 1851446959
Provider Name (Legal Business Name): JENIAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5930 ALBERVAN ST
SHAWNEE KS
66216-1565
US

IV. Provider business mailing address

5930 ALBERVAN ST
SHAWNEE KS
66216-1565
US

V. Phone/Fax

Practice location:
  • Phone: 913-268-4472
  • Fax: 913-268-0127
Mailing address:
  • Phone: 913-268-4472
  • Fax: 913-268-0127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARILYN E. KUBLER
Title or Position: VICE-PRESIDENT
Credential:
Phone: 913-268-4472