Healthcare Provider Details

I. General information

NPI: 1174739734
Provider Name (Legal Business Name): PSYCHIATRIC ASSOCIATES OF CENTRAL KANSAS, CHTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 W IRON AVE FL 5 SUITE A
SALINA KS
67401-2600
US

IV. Provider business mailing address

119 W IRON AVE FL 5 SUITE A
SALINA KS
67401-2600
US

V. Phone/Fax

Practice location:
  • Phone: 785-309-0355
  • Fax: 785-309-0184
Mailing address:
  • Phone: 785-309-0355
  • Fax: 785-309-0184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number04-28506
License Number StateKS

VIII. Authorized Official

Name: DR. KOFI A. ABABIO
Title or Position: DOCTOR
Credential: M.D., M.P.H.
Phone: 785-309-0355