Provider Demographics
NPI:1508290313
Name:EQUI VENTURE FARMS, LLC
Entity Type:Organization
Organization Name:EQUI VENTURE FARMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REGGI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:785-478-4148
Mailing Address - Street 1:PO BOX 210
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:KS
Mailing Address - Zip Code:66402-0210
Mailing Address - Country:US
Mailing Address - Phone:785-478-4148
Mailing Address - Fax:785-478-0279
Practice Address - Street 1:8722 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-9204
Practice Address - Country:US
Practice Address - Phone:785-478-4148
Practice Address - Fax:785-478-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100369450AMedicaid