Provider Demographics
NPI:1669893590
Name:OH YEAH INC
Entity type:Organization
Organization Name:OH YEAH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-833-6656
Mailing Address - Street 1:122 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YATES CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:66783-1422
Mailing Address - Country:US
Mailing Address - Phone:316-833-6656
Mailing Address - Fax:620-625-3218
Practice Address - Street 1:122 N MAIN ST
Practice Address - Street 2:
Practice Address - City:YATES CENTER
Practice Address - State:KS
Practice Address - Zip Code:66783-1422
Practice Address - Country:US
Practice Address - Phone:316-833-6656
Practice Address - Fax:620-625-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS200547640A251C00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200547640AMedicaid