Provider Demographics
NPI:1821162629
Name:DMP SERVICES
Entity Type:Organization
Organization Name:DMP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITEHAIR
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:785-625-8885
Mailing Address - Street 1:108 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1629
Mailing Address - Country:US
Mailing Address - Phone:785-625-8885
Mailing Address - Fax:
Practice Address - Street 1:1715 MARJORIE DRIVE
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2643
Practice Address - Country:US
Practice Address - Phone:785-625-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200258830AMedicaid