NPIMap

Organization Active NPI

Tri-Valley Developmental Services, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Chanute, KS
National Provider Identifier
1114072709
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
TRI-VALLEY DEVELOPMENTAL SERVICES, INC.
Practice address
3740 S Santa Fe Ave
Chanute, KS 66720-3247
Phone
(620) 431-7401
Fax
(620) 431-1409
NPI assigned
Jan 24, 2007
Last updated
Jun 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle Reddick
Title
Finance Director
Phone
(620) 431-7401

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
In Home Supportive Care Agency 253Z00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

3740 S Santa Fe Ave
Chanute, KS 66720-3247

Mailing address

3740 S Santa Fe Ave
P.O. Box 518
Chanute, KS 66720-3247
Phone (620) 431-7401

Other identifiers 1

IdentifierTypeStateIssuer
100041040AMedicaidKS

National Provider Directory

National Provider Directory
Tax ID family
Tri-Valley Developmental Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1114072709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 S SANTA FE AVE",
            "address_2": "P.O. BOX 518",
            "city": "CHANUTE",
            "state": "KS",
            "postal_code": "667203247",
            "telephone_number": "620-431-7401",
            "fax_number": "620-431-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 S SANTA FE AVE",
            "city": "CHANUTE",
            "state": "KS",
            "postal_code": "667203247",
            "telephone_number": "620-431-7401",
            "fax_number": "620-431-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-VALLEY DEVELOPMENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "REDDICK",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "620-431-7401"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100041040A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanute, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.