Provider Demographics
NPI:1104946003
Name:NORTH CENTRAL KANSAS SPECIAL
Entity type:Organization
Organization Name:NORTH CENTRAL KANSAS SPECIAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SP. ED. DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-543-2149
Mailing Address - Street 1:693 2ND AVE W
Mailing Address - Street 2:
Mailing Address - City:GLADE
Mailing Address - State:KS
Mailing Address - Zip Code:67639-3924
Mailing Address - Country:US
Mailing Address - Phone:785-543-2149
Mailing Address - Fax:785-543-6654
Practice Address - Street 1:693 2ND AVE W
Practice Address - Street 2:
Practice Address - City:GLADE
Practice Address - State:KS
Practice Address - Zip Code:67639-3924
Practice Address - Country:US
Practice Address - Phone:785-543-2149
Practice Address - Fax:785-543-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS100388650A251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)