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General NPI Number Information
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NPI Number | 1346213923
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Entity Type | Organization
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Legal Business Name | ADDICTION TREATMENT CENTER OF SOUTHEAST KANSAS
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 810 CEDAR ST
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City | GIRARD
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State | KS
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Zip | 66743-2056
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Country | US
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Telephone | 620-724-8806
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Fax |
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Provider Business Mailing Address
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Address Line | 911 E CENTENNIAL DR
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City | PITTSBURG
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State | KS
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Zip | 66762-6601
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Country | US
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Telephone | 620-231-5130
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Fax | 620-235-7101
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | RICHARD H PFEIFFER
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Credential | LMSW
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Telephone | 620-231-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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