Organization
MEDICALODGES, INC.
Active
Other names
New Horizons Pittsburg
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY W FISHER (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
2702 N JOPLIN ST, PITTSBURG, KS 66762-2645
(620) 231-3910
(620) 231-3912
Mailing address
2702 N JOPLIN ST, PITTSBURG, KS 66762-2645
(620) 231-3910
(620) 231-3912
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
N019005
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107330B
—
KS
Enumeration date
10/10/2006
Last updated
06/26/2008
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