Organization
BITTERSWEET HOMESTEAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA J HIATT (EXECUTIVE DIRECTOR)
(785) 872-3719
Entity
Organization
Contact information
Practice address
3181 CHAUTAUQUA RD, HOLTON, KS 66436-8032
(785) 872-3719
(785) 872-3717
Mailing address
3181 CHAUTAUQUA RD, HOLTON, KS 66436-8032
(785) 872-3719
(785) 872-3717
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100406430A
—
KS
Enumeration date
02/01/2007
Last updated
10/14/2013
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