Healthcare Provider Details

I. General information

NPI: 1245855238
Provider Name (Legal Business Name): NJOKU PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N ROCK RD UNIT 1800
WICHITA KS
67226-1341
US

IV. Provider business mailing address

3500 N ROCK RD UNIT 1800
WICHITA KS
67226-1341
US

V. Phone/Fax

Practice location:
  • Phone: 316-201-4338
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MARIAM NJOKU
Title or Position: OWNER
Credential:
Phone: 316-201-4338