Healthcare Provider Details
I. General information
NPI: 1881468965
Provider Name (Legal Business Name): SAINT FRANCIS FCT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2023
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
495 ALBION AVE
CINCINNATI OH
45246-4604
US
IV. Provider business mailing address
110 W OTIS AVE
SALINA KS
67401-8713
US
V. Phone/Fax
- Phone: 785-825-0541
- Fax:
- Phone: 785-825-0541
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSAN
CHRISTENSON
Title or Position: PROVIDER ENROLLMENT SPECIALIST
Credential:
Phone: 979-492-2795