Provider Demographics
NPI:1093975534
Name:CDDO
Entity Type:Organization
Organization Name:CDDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CDDO DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-826-2511
Mailing Address - Street 1:528 N STEVENSON ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3333
Mailing Address - Country:US
Mailing Address - Phone:913-782-2737
Mailing Address - Fax:
Practice Address - Street 1:528 N STEVENSON ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3333
Practice Address - Country:US
Practice Address - Phone:913-782-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KMAP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health