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General NPI Number Information
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NPI Number | 1689727208
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Entity Type | Organization
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Legal Business Name | GREAT PLAINS OF OTTAWA CO INC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 215 E 8TH ST
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City | MINNEAPOLIS
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State | KS
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Zip | 67467-1908
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Country | US
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Telephone | 785-392-2122
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Fax | 785-392-2852
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Provider Business Mailing Address
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Address Line | PO BOX 290
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City | MINNEAPOLIS
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State | KS
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Zip | 67467-0290
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Country | US
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Telephone | 785-392-2122
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Fax | 785-392-2852
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JODY PARKS
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Credential |
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Telephone | 785-392-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | H072001
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License Number State | KS
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