Twin Rivers Developmental Supports Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

TWIN RIVERS DEVELOPMENTAL SUPPORTS INC

Practice address

22179 D Street
Strother Field Industrial Park
Arkansas City, KS 67005-0133

Phone

(620) 442-3575

Fax

(620) 442-3733

NPI assigned

Mar 19, 2007

Last updated

Jul 23, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John F Boyle

Title

Cfo

Phone

(620) 442-3575

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1679697445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 133",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670050133",
            "telephone_number": "620-442-3575",
            "fax_number": "620-442-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22179 D STREET",
            "address_2": "STROTHER FIELD INDUSTRIAL PARK",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670050133",
            "telephone_number": "620-442-3575",
            "fax_number": "620-442-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN RIVERS DEVELOPMENTAL SUPPORTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-442-3575",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100362030B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100362030A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Arkansas City, KS
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• Case Management Agency in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.