Healthcare Provider Details

I. General information

NPI: 1417769282
Provider Name (Legal Business Name): C EDWARDS CONCEPTS, LLC PUBLIC HEALTH AND DEVELOPMENT CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 W 110TH ST STE 300
OVERLAND PARK KS
66211-1221
US

IV. Provider business mailing address

5440 W 110TH ST STE 300
OVERLAND PARK KS
66211-1221
US

V. Phone/Fax

Practice location:
  • Phone: 318-751-3815
  • Fax:
Mailing address:
  • Phone: 318-751-3815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLETTE EDWARDS
Title or Position: DIRECTOR
Credential: MSPH, LAC,AADC, CMAT
Phone: 318-751-3815