Organization
KINGS CAMP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY MAY PAASCH (OFFICE MANAGER)
(316) 794-2913
Entity
Organization
Contact information
Practice address
24401 W MACARTHUR RD, GODDARD, KS 67052-8713
(316) 794-2913
(316) 794-2773
Mailing address
PO BOX 215, GODDARD, KS 67052-0215
(316) 794-2913
(316) 794-2773
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
2084P0800X
KS
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
251B00000X
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103575
BLUE CROSS & BLUE SHIELD
KS
Enumeration date
06/11/2005
Last updated
08/22/2020
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