Provider Demographics
NPI:1588012637
Name:STEADFAST ADVOCACY FOR MEANINGFUL INDEPENDENCE LLC
Entity Type:Organization
Organization Name:STEADFAST ADVOCACY FOR MEANINGFUL INDEPENDENCE LLC
Other - Org Name:SAMI LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOLDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-285-8424
Mailing Address - Street 1:614 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534-1520
Mailing Address - Country:US
Mailing Address - Phone:785-285-8424
Mailing Address - Fax:
Practice Address - Street 1:614 N 14TH ST
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534-1520
Practice Address - Country:US
Practice Address - Phone:785-285-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management