Provider Demographics
NPI:1285638858
Name:CENTER FOR INDEPENDENT LIVIND FOR SW KS
Entity Type:Organization
Organization Name:CENTER FOR INDEPENDENT LIVIND FOR SW KS
Other - Org Name:CILSWKS
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCIAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOBMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-276-1900
Mailing Address - Street 1:111 W GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5412
Mailing Address - Country:US
Mailing Address - Phone:620-276-1900
Mailing Address - Fax:620-271-0200
Practice Address - Street 1:111 W GRANT AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5412
Practice Address - Country:US
Practice Address - Phone:620-276-1900
Practice Address - Fax:620-271-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management