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113 W Main St Arlington KS 67514-9701 | |
| (620) 931-8869 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 113 W Main St, Arlington, Kansas |
| Authorized Official Name and Position | Amanda Buckner (OWNER/OPERATOR) |
| Authorized Official Contact | 6209318869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 273 Arlington KS 67514-0273 Ph: () - | 113 W Main St Arlington KS 67514-9701 Ph: (620) 931-8869 |
| NPI Number | 1346894300 |
|---|---|
| Provider Enumeration Date | 07/29/2019 |
| Last Update Date | 08/10/2023 |
| Certification Date | 08/10/2023 |
| Medicare PECOS PAC ID | 3375972847 |
|---|---|
| Medicare Enrollment ID | O20200403001601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346894300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Amanda Buckner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659678498 PECOS PAC ID: 2365871837 Enrollment ID: I20200403001710 |