Healthcare Provider Details

I. General information

NPI: 1912814351
Provider Name (Legal Business Name): SOUTH CENTRAL REGIONAL MENTAL HEALTH HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 S CUSTER AVE
WICHITA KS
67217-1202
US

IV. Provider business mailing address

200 W DOUGLAS AVE STE 600
WICHITA KS
67202-3006
US

V. Phone/Fax

Practice location:
  • Phone: 316-247-7000
  • Fax:
Mailing address:
  • Phone: 785-596-3154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MISS TANISHA MASON
Title or Position: ACCREDITATION MANAGER
Credential:
Phone: 785-596-3154