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General NPI Number Information
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NPI Number | 1629884143
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Entity Type | Organization
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Legal Business Name | KATIES WAY JUNCTION CITY
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 206 E ASH ST
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City | JUNCTION CITY
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State | KS
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Zip | 66441-1439
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Country | US
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Telephone | 857-751-1287
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Fax | 785-530-6641
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Provider Business Mailing Address
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Address Line | 206 E ASH ST
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City | JUNCTION CITY
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State | KS
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Zip | 66441-1439
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Country | US
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Telephone | 857-751-1287
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Fax | 785-530-6641
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Authorized Official
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Title or Position | CREDENTIALING DIRECTOR
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Name | KELLY JOHNSON
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Credential |
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Telephone | 785-320-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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