Provider Demographics
NPI:1568483634
Name:STATE OF KANSAS
Entity Type:Organization
Organization Name:STATE OF KANSAS
Other - Org Name:HEARING AND SPEECH DEPARTMENT / HARTLEY FAMILY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHAIR - HEARING & SPEECH DEPT.
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A,
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:913-588-5937
Mailing Address - Street 1:HARTLEY FAMILY CENTER M.S. 3047
Mailing Address - Street 2:3901 RAINBOW BLVD.
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-5750
Mailing Address - Fax:913-588-8948
Practice Address - Street 1:HARTLEY FAMILY CENTER M.S. 3047
Practice Address - Street 2:3901 RAINBOW BLVD
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-5750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF KANSAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-22
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100008080FMedicaid