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General NPI Number Information
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NPI Number | 1316300239
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Entity Type | Organization
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Legal Business Name | TAPESTRY PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 529 N LINCOLN AVE
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City | LIBERAL
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State | KS
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Zip | 67901-3309
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Country | US
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Telephone | 620-417-3106
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Fax | 620-624-4050
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Provider Business Mailing Address
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Address Line | 504 N KANSAS AVE SUITE B
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City | LIBERAL
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State | KS
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Zip | 67901-3346
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Country | US
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Telephone | 620-604-5274
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Fax | 844-704-5822
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Authorized Official
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Title or Position | CREDENTIALING
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Name | TIFFANY BURROWS
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Credential |
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Telephone | 620-275-0644
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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 | 76030
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License Number State | KS
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