Organization
CREATIVE COMMUNITY LIVING OF SOUTH CENTRAL KANSAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMI SHAW (CFO)
(620) 221-9431
Entity
Organization
Contact information
Practice address
1500 E 8TH AVE, SUITE 201, WINFIELD, KS 67156-3104
(620) 221-9431
(620) 221-9336
Mailing address
1500 E 8TH AVE, SUITE 201, WINFIELD, KS 67156-3104
(620) 221-9431
(620) 221-9336
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/01/2007
Last updated
11/22/2013
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