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General NPI Number Information
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NPI Number | 1245949684
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Entity Type | Organization
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Legal Business Name | CORTERRA OF WICHITA, LLC
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 7447 W VILLAGE CIR
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City | WICHITA
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State | KS
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Zip | 67205
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Country | US
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Telephone | 316-637-2889
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Fax | 316-368-3177
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Provider Business Mailing Address
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Address Line | 7447 W VILLAGE CIR
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City | WICHITA
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State | KS
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Zip | 67205
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Country | US
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Telephone | 316-637-2889
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Fax | 316-368-3177
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Authorized Official
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Title or Position | CEO/CHAIRMAN
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Name | ERIK HATTEN
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Credential |
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Telephone | 316-640-8427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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