Provider Demographics
NPI:1770283574
Name:GREAT PLAINS OF OTTAWA CO, INC.
Entity type:Organization
Organization Name:GREAT PLAINS OF OTTAWA CO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-392-9131
Mailing Address - Street 1:215 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:KS
Mailing Address - Zip Code:67467-1907
Mailing Address - Country:US
Mailing Address - Phone:785-392-2122
Mailing Address - Fax:785-392-3369
Practice Address - Street 1:830 ELM ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:KS
Practice Address - Zip Code:67467-1608
Practice Address - Country:US
Practice Address - Phone:785-392-2144
Practice Address - Fax:785-392-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health