Healthcare Provider Details

I. General information

NPI: 1689350308
Provider Name (Legal Business Name): BESIDES MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13830 SANTA FE TRAIL DR
LENEXA KS
66215-3310
US

IV. Provider business mailing address

13830 SANTA FE TRAIL DR STE 109
LENEXA KS
66215-3381
US

V. Phone/Fax

Practice location:
  • Phone: 913-398-0220
  • Fax:
Mailing address:
  • Phone: 913-398-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LOYCE KERUBO SIRIBA
Title or Position: APRN
Credential:
Phone: 913-548-1252