=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912814351
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH CENTRAL REGIONAL MENTAL HEALTH HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2026
-----------------------------------------------------
Last Update Date | 08/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3901 S CUSTER AVE
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67217-1202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-247-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 W DOUGLAS AVE STE 600
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67202-3006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-596-3154
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACCREDITATION MANAGER
-----------------------------------------------------
Name | MISS TANISHA MASON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 785-596-3154
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 283Q00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------