Healthcare Provider Details

I. General information

NPI: 1396200564
Provider Name (Legal Business Name): FIELDVIEW HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2019
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 S HOLLAND ST
WICHITA KS
67209-2007
US

IV. Provider business mailing address

7130 W MAPLE ST # 230-125
WICHITA KS
67209-2187
US

V. Phone/Fax

Practice location:
  • Phone: 833-343-5384
  • Fax:
Mailing address:
  • Phone: 316-351-7767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC CHESS BRONK
Title or Position: CEO
Credential:
Phone: 316-927-5772