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NPI Code Detail

MEDICARE: ADDICTION TREATMENT CENTER OF SOUTHEAST KANSAS

MEDICARE: ADDICTION TREATMENT CENTER OF SOUTHEAST KANSAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1346213923
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADDICTION TREATMENT CENTER OF SOUTHEAST KANSAS
Provider Business Mailing Address
First Line : 911 E CENTENNIAL DR
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-6601
Country : US
Telephone Number : 620-231-5130
Fax Number : 620-235-7101
Provider Business Practice Location Address
First Line : 810 CEDAR ST
Second Line :
City : GIRARD
State : KS
Zip : 66743-2056
Country : US
Telephone Number : 620-724-8806
Fax Number :
Authorized Official
Title or Position : EXECUTIVE ADMINISTRATOR
Name : RICHARD H PFEIFFER
Credential : LMSW
Telephone Number : 620-231-5130
Provider Enumeration Date : 02/13/2006
Last Update Date : 08/17/2007

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Directions to “ADDICTION TREATMENT CENTER OF SOUTHEAST KANSAS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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