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General NPI Number Information
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NPI Number | 1710172473
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Entity Type | Organization
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Legal Business Name | SEQUEL OF KANSAS, LLC
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 2050 W. 11TH ST N,
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City | WICHITA
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State | KS
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Zip | 67203
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Country | US
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Telephone | 316-267-5710
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Fax | 316-267-5710
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Provider Business Mailing Address
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Address Line | 1131 EAGLETREE LANE
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City | HUNTSVILLE
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State | AL
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Zip | 35801
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Country | US
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Telephone | 256-880-3339
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Fax | 256-880-7026
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. HEATHER D. SELL
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Credential | MSM
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Telephone | 316-267-5710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 62020
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License Number State | KS
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