Organization
INDEPENDENT GUARDIAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON DECKINGER (OWNER)
(316) 880-1742
Entity
Organization
Contact information
Practice address
550 S ESTELLE ST, WICHITA, KS 67211-2909
(316) 880-1742
Mailing address
550 S ESTELLE ST, WICHITA, KS 67211-2909
(316) 880-1742
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
200566240A
KS
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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