| Vital Spark Therapy | |
|
734 Illinois St Lawrence KS 66044-2326 | |
| (913) 210-0732 | |
| Not Available |
| Full Name | Vital Spark Therapy |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 734 Illinois St, Lawrence, Kansas |
| Authorized Official Name and Position | Jacob Means (OWNER/THERAPIST) |
| Authorized Official Contact | 9132100732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Spark Therapy 734 Illinois St Lawrence KS 66044-2326 Ph: (913) 210-0732 | Vital Spark Therapy 734 Illinois St Lawrence KS 66044-2326 Ph: (913) 210-0732 |
| NPI Number | 1962215467 |
|---|---|
| Provider Enumeration Date | 01/29/2025 |
| Last Update Date | 01/29/2025 |
| Certification Date | 01/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962215467 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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