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General NPI Number Information
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NPI Number | 1679254783
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 2322 S MAIN ST
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City | FORT SCOTT
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State | KS
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Zip | 66701-3026
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Country | US
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Telephone | 620-264-6550
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Fax | 620-224-2502
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Provider Business Mailing Address
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Address Line | PO BOX 1832
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City | PITTSBURG
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State | KS
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Zip | 66762-1832
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | DANIEL SPENCER CREITZ
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Credential |
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Telephone | 620-240-5015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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