Provider Demographics
NPI:1356483572
Name:TWIN VALLEY DEVELOPMENTAL SERVICES, INC.
Entity Type:Organization
Organization Name:TWIN VALLEY DEVELOPMENTAL SERVICES, INC.
Other - Org Name:INFANT AND TODDLER SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-747-7903
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:GREENLEAF
Mailing Address - State:KS
Mailing Address - Zip Code:66943-0219
Mailing Address - Country:US
Mailing Address - Phone:785-747-7903
Mailing Address - Fax:785-747-2605
Practice Address - Street 1:412 PARK ST.
Practice Address - Street 2:
Practice Address - City:GREENLEAF
Practice Address - State:KS
Practice Address - Zip Code:66943-0219
Practice Address - Country:US
Practice Address - Phone:785-747-7903
Practice Address - Fax:785-747-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115069OtherOT, PT, AND SLP