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General NPI Number Information
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NPI Number | 1861585473
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Entity Type | Organization
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Legal Business Name | ADOLESCENT SPECIALISTS OF KANSAS, INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 650 NORTH CARRIAGE PARKWAY SUITE 135
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City | WICHITA
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State | KS
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Zip | 67208-4514
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Country | US
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Telephone | 316-685-4700
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Fax | 316-685-8247
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Provider Business Mailing Address
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Address Line | 650 NORTH CARRIAGE PARKWAY SUITE 135
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City | WICHITA
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State | KS
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Zip | 67208-4514
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Country | US
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Telephone | 316-685-4700
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Fax | 316-685-8247
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. ANNE M DOLAN
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Credential |
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Telephone | 316-685-4700
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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 | 619
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License Number State | KS
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