Provider Demographics
NPI:1285037721
Name:SENIOR SERVICES OF SOUTHEAST KANSAS INC.
Entity Type:Organization
Organization Name:SENIOR SERVICES OF SOUTHEAST KANSAS INC.
Other - Org Name:SENIOR SERVICES OF SEK, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-251-7313
Mailing Address - Street 1:PO BOX 1415
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-6715
Mailing Address - Country:US
Mailing Address - Phone:620-251-7313
Mailing Address - Fax:620-251-1716
Practice Address - Street 1:618 UNION ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-6020
Practice Address - Country:US
Practice Address - Phone:620-251-7313
Practice Address - Fax:620-251-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS100361530B332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100361530BMedicaid