| Kansas Children's Service League | |
|
1365 N Custer Wichita KS 67203 | |
| (316) 942-4261 | |
| (316) 943-9995 |
| Full Name | Kansas Children's Service League |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1365 N Custer, Wichita, Kansas |
| Authorized Official Name and Position | Pamela Cornwell (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 3169424261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kansas Children's Service League 1365 N Custer Wichita KS 67203 Ph: (316) 942-4261 | Kansas Children's Service League 1365 N Custer Wichita KS 67203 Ph: (316) 942-4261 |
| NPI Number | 1083828362 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083828362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 229 (Kansas) | Primary |
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