Healthcare Provider Details
I. General information
NPI: 1346576899
Provider Name (Legal Business Name): HEALTHY OPTIONS FOR KANSAS COMMUNITIES (HOP), INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2009
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3620 E SUNNYBROOK LN
WICHITA KS
67210-1464
US
IV. Provider business mailing address
3620 E SUNNYBROOK LN
WICHITA KS
67210-1464
US
V. Phone/Fax
- Phone: 316-651-0062
- Fax: 316-295-2623
- Phone: 316-651-0062
- Fax: 316-295-2623
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: PROF.
RUTH
PICKARD
Title or Position: EXCUTIVE DIRECTOR
Credential:
Phone: 316-651-0062