Provider Demographics
NPI:1891596227
Name:MCDONALD RESIDENTIAL SERVICE
Entity type:Organization
Organization Name:MCDONALD RESIDENTIAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-228-0175
Mailing Address - Street 1:2231 US HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-3058
Mailing Address - Country:US
Mailing Address - Phone:620-228-0175
Mailing Address - Fax:
Practice Address - Street 1:2231 US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3058
Practice Address - Country:US
Practice Address - Phone:620-228-0175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health