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General NPI Number Information
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NPI Number | 1619909181
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Entity Type | Organization
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Legal Business Name | KANZA MENTAL HEALTH AND GUIDANCE CENTER, INC.
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 909 S 2ND ST
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City | HIAWATHA
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State | KS
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Zip | 66434-2774
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Country | US
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Telephone | 785-742-7113
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Fax | 785-742-3085
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Provider Business Mailing Address
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Address Line | 909 SOUTH 2ND STREET PO BOX 319
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City | HIAWATHA
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State | KS
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Zip | 66434-0319
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Country | US
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Telephone | 785-742-7113
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Fax | 785-742-3085
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Authorized Official
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Title or Position | CEO
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Name | MR. BILLY D PERSINGER JR.
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Credential |
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Telephone | 785-742-7113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 013
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 013
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 013
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License Number State | KS
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