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General NPI Number Information
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NPI Number | 1407572514
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Entity Type | Organization
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Legal Business Name | GREAT PLAINS MENTAL HEALTH PARTNERS INC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 206 CLAYTON ST
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City | BRUSH
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State | CO
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Zip | 80723-2104
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Country | US
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Telephone | 970-467-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 206 CLAYTON ST
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City | BRUSH
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State | CO
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Zip | 80723-2104
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Country | US
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Telephone | 720-734-2867
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRYAN JOHN ECKHARD
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Credential | PMHNP
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Telephone | 970-467-7707
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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 |
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License Number State |
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