Provider Demographics
NPI:1235231499
Name:DECATUR HEALTH SYSTEMS,INC.
Entity Type:Organization
Organization Name:DECATUR HEALTH SYSTEMS,INC.
Other - Org Name:COTTONWOOD HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:785-475-2208
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67749-0268
Mailing Address - Country:US
Mailing Address - Phone:785-475-2208
Mailing Address - Fax:785-475-2453
Practice Address - Street 1:810 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:KS
Practice Address - Zip Code:67749-2450
Practice Address - Country:US
Practice Address - Phone:785-475-2208
Practice Address - Fax:785-475-2453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-020-002251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100413880BMedicaid
KS100413880CMedicaid
KS177236Medicare Oscar/Certification
KS100413880BMedicaid