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Organization

COUNTRY CARE RESIDENTIAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOYCE ANN MALEY (PROVIDER)
(620) 365-6033
Entity
Organization

Contact information

Practice address
11 HOLIDAY CT, IOLA, KS 66749-1515
(620) 228-8316
(620) 365-6033
Mailing address
1036 2200TH ST, IOLA, KS 66749-3085
(620) 365-6033

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
1720405582
KS
Enumeration date
03/18/2014
Last updated
03/31/2014
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