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General NPI Number Information
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NPI Number | 1558554881
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Entity Type | Organization
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Legal Business Name | DJKIERL, INC.
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 736 HEYLMAN ST
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City | FORT SCOTT
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State | KS
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Zip | 66701-2433
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Country | US
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Telephone | 620-223-3120
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Fax | 620-223-1560
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Provider Business Mailing Address
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Address Line | 214 S. 10TH ST
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City | MOUND CITY
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State | KS
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Zip | 66056-5265
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Country | US
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Telephone | 913-795-2637
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Fax | 913-795-2637
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAYMOND D. KIERL
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Credential |
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Telephone | 913-795-2637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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