Healthcare Provider Details

I. General information

NPI: 1356640007
Provider Name (Legal Business Name): HEALTHY RECOVERY OPTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15460 ROBINSON ST
OVERLAND PARK KS
66223-2891
US

IV. Provider business mailing address

10540 BARKLEY ST STE 269
OVERLAND PARK KS
66212-1842
US

V. Phone/Fax

Practice location:
  • Phone: 913-748-7831
  • Fax:
Mailing address:
  • Phone: 913-748-7831
  • Fax: 913-660-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number138
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. PETUNIA M MONCHUSIE
Title or Position: MENTAL HEALTH PROFESSIONAL
Credential: PH.D., RAODAC, AAPS
Phone: 913-748-7831