| Awakenings | |
|
5300 W 94th Ter Ste 200 Prairie Village KS 66207-2536 | |
| (913) 381-8555 | |
| (913) 677-2112 |
| Full Name | Awakenings |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5300 W 94th Ter Ste 200, Prairie Village, Kansas |
| Authorized Official Name and Position | Magdalen Gustilo (DIRECTOR OF PAYER RELATIONS) |
| Authorized Official Contact | 7145687667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awakenings 5300 W 94th Ter Ste 200 Prairie Village KS 66207-2536 Ph: (913) 381-8555 | Awakenings 5300 W 94th Ter Ste 200 Prairie Village KS 66207-2536 Ph: (913) 381-8555 |
| NPI Number | 1154535060 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/05/2023 |
| Medicare PECOS PAC ID | 7810135209 |
|---|---|
| Medicare Enrollment ID | O20130523000701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154535060 | NPI | - | NPPES |
| 203768908-A | Medicaid | MO | |
| 100384540B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0427007 (Kansas) | Primary |
| 2084P0802X | Psychiatry & Neurology - Addiction Psychiatry | 0427007 (Kansas) | Secondary |
| Provider Name | Maria C Davila |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255404232 PECOS PAC ID: 1254477235 Enrollment ID: I20091005000571 |
| Provider Name | Zachary K Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376004630 PECOS PAC ID: 5092041095 Enrollment ID: I20190730000433 |
Kansas City Behavior Analysts Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7941 Maple Ln, Prairie Village, KS 66208 Phone: 913-248-5510 | |
Leslie A Abbey, L.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 W 75th St, Suite 120, Prairie Village, KS 66208 Phone: 913-262-2950 Fax: 913-384-4629 | |
Rosemarie A Romain-tyson Sole Mbr Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4121 W 83rd St, 254, Prairie Village, KS 66208 Phone: 913-381-7500 Fax: 913-381-7505 | |
Fernando Rosso Md Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8340 Mission Rd Ste 210, Prairie Village, KS 66206 Phone: 913-642-0100 Fax: 913-642-0176 | |
Creating Connections Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9100 Mission Rd, Prairie Village, KS 66206 Phone: 913-735-3393 Fax: 913-828-6898 | |
Aim Mental Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8340 Mission Rd Ste 210, Prairie Village, KS 66206 Phone: 913-642-0100 |