Healthcare Provider Details

I. General information

NPI: 1093580532
Provider Name (Legal Business Name): SJS VENTURES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N 98TH ST
EDWARDSVILLE KS
66111-1403
US

IV. Provider business mailing address

33 N 98TH ST
EDWARDSVILLE KS
66111-1403
US

V. Phone/Fax

Practice location:
  • Phone: 913-954-9114
  • Fax:
Mailing address:
  • Phone: 913-954-9114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHELDON SCHELLING
Title or Position: PRESIDENT
Credential: LSCSW
Phone: 913-954-9114