| Sandstone Bridge Center, Llc | |
|
134 S Santa Fe Ave Suite 130 Salina KS 67401-2877 | |
| (785) 823-7400 | |
| (785) 823-7400 |
| Full Name | Sandstone Bridge Center, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 134 S Santa Fe Ave, Salina, Kansas |
| Authorized Official Name and Position | Mindy J Nicholson (OWNER) |
| Authorized Official Contact | 7858237400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandstone Bridge Center, Llc 134 S Santa Fe Ave Suite 130 Salina KS 67401-2877 Ph: (785) 823-7400 | Sandstone Bridge Center, Llc 134 S Santa Fe Ave Suite 130 Salina KS 67401-2877 Ph: (785) 823-7400 |
| NPI Number | 1982901724 |
|---|---|
| Provider Enumeration Date | 02/14/2011 |
| Last Update Date | 07/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982901724 | NPI | - | NPPES |
| 200630800A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 403 (Kansas) | Secondary |
| 106H00000X | Marriage & Family Therapist | 854 (Kansas) | Primary |
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