Provider Demographics
NPI:1962682831
Name:BMW ENTERPRISE
Entity Type:Organization
Organization Name:BMW ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOECKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-625-0015
Mailing Address - Street 1:1340A 280TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-9753
Mailing Address - Country:US
Mailing Address - Phone:785-625-0015
Mailing Address - Fax:785-625-0015
Practice Address - Street 1:1340A 280TH AVE
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-9753
Practice Address - Country:US
Practice Address - Phone:785-625-0015
Practice Address - Fax:785-625-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS200516660A251C00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200516660AMedicaid