Organization
BIG LAKES DEVELOPMENTAL CENTER INC
Active
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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