Healthcare Provider Details

I. General information

NPI: 1467120303
Provider Name (Legal Business Name): HALCYON BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 NW HODGES RD
SILVER LAKE KS
66539-9451
US

IV. Provider business mailing address

4041 NW HODGES RD
SILVER LAKE KS
66539-9451
US

V. Phone/Fax

Practice location:
  • Phone: 785-670-0370
  • Fax:
Mailing address:
  • Phone: 785-670-0370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY PATRICK
Title or Position: OWNER
Credential: LSCSW
Phone: 785-670-0370