Provider Demographics
NPI:1710315411
Name:THE GREEN EXPRESS STUDIO
Entity type:Organization
Organization Name:THE GREEN EXPRESS STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:
Authorized Official - Last Name:SORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-381-0607
Mailing Address - Street 1:8029 OVERLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-3744
Mailing Address - Country:US
Mailing Address - Phone:913-381-0607
Mailing Address - Fax:913-381-0607
Practice Address - Street 1:8029 OVERLAND PARK DR
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-3744
Practice Address - Country:US
Practice Address - Phone:913-381-0607
Practice Address - Fax:913-381-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services