Provider Demographics
NPI:1679629364
Name:HETLINGER DEVELOPMENTAL SERVICES, INC.
Entity Type:Organization
Organization Name:HETLINGER DEVELOPMENTAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLUNKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-342-1087
Mailing Address - Street 1:707 S COMMERCIAL ST
Mailing Address - Street 2:P.O. BOX 2204
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-8804
Mailing Address - Country:US
Mailing Address - Phone:620-342-1087
Mailing Address - Fax:620-342-0558
Practice Address - Street 1:707 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-8804
Practice Address - Country:US
Practice Address - Phone:620-342-1087
Practice Address - Fax:620-342-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management