Mary Ann Dvorachek

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MARY ANN DVORACHEK

Doing business as

Valiant Endeavors

Practice address

1021 Connecticut St
Lawrence, KS 66044-3037

Phone

(620) 365-7174

NPI assigned

Feb 24, 2021

Organization subpart

No

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

Authorized official

Name

Mary Ann Dvorachek

Title

Director

Phone

(620) 365-7174

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Valiant Endeavors Doing business as

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1497349039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N KENTUCKY ST",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667491931",
            "telephone_number": "620-365-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 CONNECTICUT ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660443037",
            "telephone_number": "620-365-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN DVORACHEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "DVORACHEK",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "620-365-7174"
    },
    "taxonomies": [
        {
            "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": "100449780",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valiant Endeavors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Martinez
• Leonel Martinez, M.D.
• Mallory Glynnis Martinez, MD
• David Marx
• Lisa Marie Marx, LMSW
• Hannah Mason, LMT
• Lillian Darcy Mason
• Winona Lea Masquat, RN
• Cynthia Mast, PA
• Cassandra Mathes

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lawrence, KS
• Providers in Lawrence, KS by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.