| Women's Recovery Center-young Women | |
|
1319 W May St Wichita KS 67213-3505 | |
| (316) 262-0505 | |
| (316) 262-7384 |
| Full Name | Women's Recovery Center-young Women |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1319 W May St, Wichita, Kansas |
| Authorized Official Name and Position | Kerye J Jackson (CFO) |
| Authorized Official Contact | 7858414138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Women's Recovery Center-young Women 3312 Clinton Pkwy Lawrence KS 66047-3624 Ph: (785) 841-4138 | Women's Recovery Center-young Women 1319 W May St Wichita KS 67213-3505 Ph: (316) 262-0505 |
| NPI Number | 1699898213 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699898213 | NPI | - | NPPES |
| 100106740D | Medicaid | KS | |
| 929460 | Other | KS | CENPATICO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 279 (Kansas) | Primary |
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