Organization
310 AVENUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L WARREN (OWNER)
(785) 623-7470
Entity
Organization
Contact information
Practice address
1012 E US HIGHWAY 40 BYP, HAYS, KS 67601-3961
(785) 623-7470
Mailing address
PO BOX 747, HAYS, KS 67601-0747
(785) 623-7470
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100035620A
—
KS
Enumeration date
01/07/2014
Last updated
01/07/2014
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