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NPI Code Detail

MEDICARE: MARILLAC CENTER, INC.

MEDICARE: MARILLAC CENTER, INC.
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
1323P00000XPsychiatric Residential Treatment Facility0054352002KS
2322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility0053702002KS

General Provider Information

NPI Number : 1750361119
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARILLAC CENTER, INC.
Provider Business Mailing Address
First Line : 8000 W 127TH ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66213-2714
Country : US
Telephone Number : 816-508-3300
Fax Number : 816-508-3321
Provider Business Practice Location Address
First Line : 8000 W 127TH ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66213-2714
Country : US
Telephone Number : 816-508-3300
Fax Number : 816-508-3321
Authorized Official
Title or Position : PRESIDENT CEO
Name : MR. MARK S RICHARDS
Credential : MA
Telephone Number : 816-508-3300
Provider Enumeration Date : 01/20/2006
Last Update Date : 09/11/2025

Similar Medicare Providers

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Practice Location Address:
8000 W 127TH ST
OVERLAND PARK, KS
66213-2714
Practice Phone: 913-574-3800
Practice Fax:
1316052723 — MS. LUCINDA JEAN WHITNEY ARNP, BC
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66213-2714
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1063506202 — ANNE F STANTON ARNP
Practice Location Address:
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Practice Phone: 913-588-6300
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1457410342 — MR. DENNIS RAY DUNMYER II LSCSW
Practice Location Address:
8000 W 127TH ST
OVERLAND PARK, KS
66213-2714
Practice Phone: 816-508-3339
Practice Fax: 816-508-3302
1134288020 — MRS. JANET ANNETTE GLENSKI PETERSON MA, ATR-BC, LPC,LCPC
Practice Location Address:
8000 W 127TH ST
OVERLAND PARK, KS
66213-2714
Practice Phone: 816-508-3346
Practice Fax: 816-508-3321
1144389669 — MRS. DEENA DEMENT LMFT
Practice Location Address:
8000 W 127TH ST
OVERLAND PARK, KS
66213-2714
Practice Phone: 816-508-3345
Practice Fax: 816-508-3321

Directions to “MARILLAC CENTER, INC. ” Practice Location

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