Provider Demographics
NPI:1356773055
Name:JOHNSON COUNTY DEVELOPMENTAL SUPPORTS
Entity type:Organization
Organization Name:JOHNSON COUNTY DEVELOPMENTAL SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VONAHNEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-826-2631
Mailing Address - Street 1:10501 LACKMAN RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1223
Mailing Address - Country:US
Mailing Address - Phone:913-826-2626
Mailing Address - Fax:913-826-2627
Practice Address - Street 1:10501 LACKMAN RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1223
Practice Address - Country:US
Practice Address - Phone:913-826-2626
Practice Address - Fax:913-826-2627
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNSON COUNTY GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management