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Organization

ARROWHEAD WEST, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LORI PENDERGAST (PRESIDENT)
(620) 227-8803
Entity
Organization

Contact information

Practice address
1100 E WYATT EARP BLVD, DODGE CITY, KS 67801-5337
(620) 227-8803
(620) 227-8812
Mailing address
1100 E WYATT EARP BLVD, DODGE CITY, KS 67801-5337
(620) 227-8803
(620) 227-8812

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
171WV0202X
Vehicle Modifications Contractor
Primary
251C00000X
Developmentally Disabled Services Day Training Agency
251E00000X
Home Health Agency
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
3747P1801X
Personal Care Attendant

Other

Enumeration date
03/15/2006
Last updated
09/11/2025
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