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General NPI Number Information
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NPI Number | 1164831418
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Entity Type | Organization
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Legal Business Name | SUNFLOWER WELLNESS RETREAT
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 29875 W 339TH ST
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City | OSAWATOMIE
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State | KS
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Zip | 66064-4159
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Country | US
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Telephone | 913-481-9389
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Fax |
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Provider Business Mailing Address
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Address Line | 29875 W 339TH ST
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City | OSAWATOMIE
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State | KS
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Zip | 66064-4159
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Country | US
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Telephone | 913-481-9389
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JOSEPH WILLIAM HAMMER
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Credential |
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Telephone | 913-481-9389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 001Y003D
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 001Y003D
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number | 001Y003D
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 001Y003D
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License Number State | KS
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