Organization
SPRING VALLEY REGIONAL CENTER FOR YOUTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD BOLIN BS (PRESIDENT)
(620) 762-2212
Entity
Organization
Contact information
Practice address
217 E 14TH ST, BAXTER SPRINGS, KS 66713-1804
(620) 762-2212
Mailing address
PO BOX 662, BAXTER SPRINGS, KS 66713-0662
(620) 856-2212
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
MC-646-227-C
KS
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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