Healthcare Provider Details

I. General information

NPI: 1841988433
Provider Name (Legal Business Name): SPRING RIVER MENTAL HEALTH & WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6610 SE QUAKERVALE RD
RIVERTON KS
66770-4185
US

IV. Provider business mailing address

PO BOX 550
RIVERTON KS
66770-0550
US

V. Phone/Fax

Practice location:
  • Phone: 620-848-2300
  • Fax: 620-848-2304
Mailing address:
  • Phone: 620-848-2300
  • Fax: 620-848-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STACY MANBECK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 620-848-2300