Organization
KARICARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN J FERNENGEL (OWNER)
(913) 220-5494
Entity
Organization
Contact information
Practice address
17258 SPRINGDALE RD, LEAVENWORTH, KS 66048-7609
(913) 682-2057
Mailing address
17258 SPRINGDALE RD, LEAVENWORTH, KS 66048-7609
(913) 682-2057
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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