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Organization

BIG LAKES DEVELOPMENTAL CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILLIP KORENEK (CFO)
(785) 776-9201
Entity
Organization

Contact information

Practice address
1416 HAYES DR, MANHATTAN, KS 66502-5066
(785) 776-9201
(785) 776-9830
Mailing address
1416 HAYES DR, MANHATTAN, KS 66502-5066
(785) 776-9201
(785) 776-9830

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
251B00000X
Case Management Agency
KS
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
KS
251E00000X
Home Health Agency
332BC3200X
Customized Equipment (DME)
KS
3747P1801X
Personal Care Attendant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100008410A
KS
05
100009080B
KS
Enumeration date
04/09/2007
Last updated
03/06/2014
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