Healthcare Provider Details

I. General information

NPI: 1841628351
Provider Name (Legal Business Name): CARITAS CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2013
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 N 7TH ST
LEAVENWORTH KS
66048-1422
US

IV. Provider business mailing address

818 N 7TH ST
LEAVENWORTH KS
66048-1422
US

V. Phone/Fax

Practice location:
  • Phone: 913-651-8860
  • Fax: 913-682-4409
Mailing address:
  • Phone: 913-651-8860
  • Fax: 913-682-4409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE M. NOONAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 913-321-2626