Healthcare Provider Details

I. General information

NPI: 1396672622
Provider Name (Legal Business Name): DIVERSIFIED EMPOWERMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 S SHORE DR
VASSAR KS
66543-9186
US

IV. Provider business mailing address

2208 S SHORE DR
VASSAR KS
66543-9186
US

V. Phone/Fax

Practice location:
  • Phone: 620-292-1414
  • Fax:
Mailing address:
  • Phone: 620-292-1414
  • Fax:

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. ERIKA JO SWANDER
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 620-292-1414