Provider Demographics
NPI:1679610539
Name:COUNTY OF SEDGWICK
Entity Type:Organization
Organization Name:COUNTY OF SEDGWICK
Other - Org Name:CENTRAL PLAINS AREA AGENCY ON AGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:316-660-5221
Mailing Address - Street 1:271 W 3RD ST STE 500
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1223
Mailing Address - Country:US
Mailing Address - Phone:316-660-7298
Mailing Address - Fax:316-660-1936
Practice Address - Street 1:271 W 3RD ST N STE 500
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-1223
Practice Address - Country:US
Practice Address - Phone:316-660-5299
Practice Address - Fax:316-660-1936
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SEDGWICK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-31
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100260940AMedicaid