| Prairie View, Inc. | |
|
1102 Hospital Dr Mcpherson KS 67460-2318 | |
| (620) 245-5000 | |
| (620) 245-5099 |
| Full Name | Prairie View, Inc. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1102 Hospital Dr, Mcpherson, Kansas |
| Authorized Official Name and Position | Marcy Johnson (PRESIDENT & CEO) |
| Authorized Official Contact | 3162846310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie View, Inc. Po Box 467 Newton KS 67114-0467 Ph: (316) 284-6400 | Prairie View, Inc. 1102 Hospital Dr Mcpherson KS 67460-2318 Ph: (620) 245-5000 |
| NPI Number | 1720181936 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720181936 | NPI | - | NPPES |
| 100005670D | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 998 (Kansas) | Primary |
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