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General NPI Number Information
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NPI Number | 1235650888
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Entity Type | Organization
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Legal Business Name | PERSONALIZED BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/14/2017
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Provider Practice Location Address
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Address Line | 5040 SW 28TH ST STE B
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City | TOPEKA
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State | KS
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Zip | 66614-2302
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 3318 NW BENT TREE LN
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City | TOPEKA
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State | KS
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Zip | 66618-3477
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Country | US
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Telephone | 785-230-2377
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DANA LE'ANN MEINHARDT
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Credential | NURSE PRACTITIONER
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Telephone | 785-380-9725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5376939
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License Number State | KS
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