| Mooncalf, Llc | |
|
6029 Broadmoor St Unit 234 Mission KS 66201-2475 | |
| (515) 758-0358 | |
| Not Available |
| Full Name | Mooncalf, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6029 Broadmoor St Unit 234, Mission, Kansas |
| Authorized Official Name and Position | Cassandra Walker (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5157580358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mooncalf, Llc 6029 Broadmoor St Unit 234 Mission KS 66201-2475 Ph: (515) 758-0358 | Mooncalf, Llc 6029 Broadmoor St Unit 234 Mission KS 66201-2475 Ph: (515) 758-0358 |
| NPI Number | 1942823034 |
|---|---|
| Provider Enumeration Date | 05/22/2020 |
| Last Update Date | 05/22/2020 |
| Certification Date | 05/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942823034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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