Provider Demographics
NPI:1811324718
Name:ENVISION INDUSTRIES INC
Entity type:Organization
Organization Name:ENVISION INDUSTRIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONTEFERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-440-1501
Mailing Address - Street 1:2301 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-4819
Mailing Address - Country:US
Mailing Address - Phone:316-267-2244
Mailing Address - Fax:316-267-9034
Practice Address - Street 1:2301 S WATER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-4819
Practice Address - Country:US
Practice Address - Phone:316-267-2244
Practice Address - Fax:316-267-9034
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENVISION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100032910CMedicaid