1497495386 NPI number — WYANDOT CENTER FOR COMMUNITY BEHAVIORAL HEALTHCARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497495386 NPI number — WYANDOT CENTER FOR COMMUNITY BEHAVIORAL HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WYANDOT CENTER FOR COMMUNITY BEHAVIORAL HEALTHCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497495386
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
757 ARMSTRONG AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66101-2701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-233-3315
Provider Business Mailing Address Fax Number:
913-233-3350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 N 47TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102-1705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-233-3300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MAIWALD
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
913-233-3315

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com