Provider Demographics
NPI:1285847046
Name:MARSHALL COUNTY INFANT TODDLER SERVICES
Entity Type:Organization
Organization Name:MARSHALL COUNTY INFANT TODDLER SERVICES
Other - Org Name:MARSHALL COUNTY COMMUNITY RESOURCE AND EDUCATION CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY SERVICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-629-8300
Mailing Address - Street 1:405 N 4TH ST
Mailing Address - Street 2:LINCOLN CENTER
Mailing Address - City:MARYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66508-1525
Mailing Address - Country:US
Mailing Address - Phone:785-629-8300
Mailing Address - Fax:785-629-8388
Practice Address - Street 1:405 N 4TH ST
Practice Address - Street 2:LINCOLN CENTER
Practice Address - City:MARYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66508-1525
Practice Address - Country:US
Practice Address - Phone:785-629-8300
Practice Address - Fax:785-629-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered251300000XAgenciesLocal Education Agency (LEA)
Not Answered251B00000XAgenciesCase Management