Healthcare Provider Details

I. General information

NPI: 1518007905
Provider Name (Legal Business Name): KVC BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21350 W 153RD ST
OLATHE KS
66061-5413
US

IV. Provider business mailing address

21350 W 153RD ST
OLATHE KS
66061-5413
US

V. Phone/Fax

Practice location:
  • Phone: 913-322-4900
  • Fax:
Mailing address:
  • Phone: 913-322-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LEA ANN JAEGER
Title or Position: ACCOUNTING MANAGER
Credential: CPA
Phone: 913-322-4934