Provider Demographics
NPI:1215058516
Name:ADVOCACY SERVICES OF WESTERN KANSAS, LLC
Entity type:Organization
Organization Name:ADVOCACY SERVICES OF WESTERN KANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-355-1468
Mailing Address - Street 1:109 ALBERT ST
Mailing Address - Street 2:
Mailing Address - City:LAKIN
Mailing Address - State:KS
Mailing Address - Zip Code:67860-9746
Mailing Address - Country:US
Mailing Address - Phone:620-355-1468
Mailing Address - Fax:620-355-1469
Practice Address - Street 1:109 ALBERT ST
Practice Address - Street 2:
Practice Address - City:LAKIN
Practice Address - State:KS
Practice Address - Zip Code:67860-9746
Practice Address - Country:US
Practice Address - Phone:620-355-1468
Practice Address - Fax:620-355-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200421960AMedicaid