Healthcare Provider Details

I. General information

NPI: 1164512562
Provider Name (Legal Business Name): RESPONSIVE MANAGEMENT CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 COLLEGE BLVD STE 250
OVERLAND PARK KS
66210-2505
US

IV. Provider business mailing address

7501 COLLEGE BLVD. SUITE 250
OVERLAND PARK KS
66210-1944
US

V. Phone/Fax

Practice location:
  • Phone: 913-451-8550
  • Fax: 913-469-5266
Mailing address:
  • Phone: 913-451-8550
  • Fax: 913-469-5266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN STEPHEN HAZEL
Title or Position: CEO
Credential: PHD
Phone: 913-451-8550