Provider Demographics
NPI:1689727208
Name:GREAT PLAINS OF OTTAWA CO INC
Entity Type:Organization
Organization Name:GREAT PLAINS OF OTTAWA CO INC
Other - Org Name:OTTAWA COUNTY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-392-2122
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:KS
Mailing Address - Zip Code:67467-0290
Mailing Address - Country:US
Mailing Address - Phone:785-392-2122
Mailing Address - Fax:785-392-2852
Practice Address - Street 1:215 E 8TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:KS
Practice Address - Zip Code:67467-1908
Practice Address - Country:US
Practice Address - Phone:785-392-2122
Practice Address - Fax:785-392-2852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH072001275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001179 BCBSOtherSWINGBED SKILLED
KS001179 BCBSOtherSWINGBED SKILLED