Healthcare Provider Details

I. General information

NPI: 1821140682
Provider Name (Legal Business Name): DONIPHAN COUNTY SERVICES AND WORKSKILLS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 E SAINT JOSEPH ST
WATHENA KS
66090-1294
US

IV. Provider business mailing address

PO BOX 69
WATHENA KS
66090-0069
US

V. Phone/Fax

Practice location:
  • Phone: 857-990-0855
  • Fax: 859-901-1086
Mailing address:
  • Phone: 785-990-0855
  • Fax: 785-990-1086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA WHITTAKER
Title or Position: OFFICE MANAGER
Credential:
Phone: 785-990-0855