Provider Demographics
NPI:1629195110
Name:JACKSON COUNTY RESOURCE CENTER, INC
Entity Type:Organization
Organization Name:JACKSON COUNTY RESOURCE CENTER, INC
Other - Org Name:JACKSON COUNTY TRAINING CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-364-3534
Mailing Address - Street 1:625 VERMONT AVE
Mailing Address - Street 2:P.O. BOX 1011
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436-2037
Mailing Address - Country:US
Mailing Address - Phone:785-364-3534
Mailing Address - Fax:785-364-4848
Practice Address - Street 1:625 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:HOLTON
Practice Address - State:KS
Practice Address - Zip Code:66436-2037
Practice Address - Country:US
Practice Address - Phone:785-364-3534
Practice Address - Fax:785-364-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health