Provider Demographics
NPI:1922775956
Name:OLATHE COMMUNITY CLINIC INC.
Entity Type:Organization
Organization Name:OLATHE COMMUNITY CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTSENPILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-323-6141
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-0529
Mailing Address - Country:US
Mailing Address - Phone:970-323-6141
Mailing Address - Fax:855-299-8071
Practice Address - Street 1:155 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2229
Practice Address - Country:US
Practice Address - Phone:970-263-3850
Practice Address - Fax:970-874-6260
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLATHE COMMUNITY CLINIC INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)