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915 E 53rd St N Park City KS 67219-2611 | |
(316) 677-7646 | |
(316) 838-0567 |
Full Name | |
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Speciality | Social Worker |
Location | 915 E 53rd St N, Park City, Kansas |
Authorized Official Name and Position | Troy Reiner (DIRECTOR) |
Authorized Official Contact | 3166195589 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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915 E 53rd St N Park City KS 67219-2611 Ph: (316) 677-7646 | 915 E 53rd St N Park City KS 67219-2611 Ph: (316) 677-7646 |
NPI Number | 1013090489 |
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Provider Enumeration Date | 10/21/2006 |
Last Update Date | 12/14/2024 |
Certification Date | 12/14/2024 |
Medicare PECOS PAC ID | 5395143390 |
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Medicare Enrollment ID | O20211006001392 |
Identifier | Type | State | Issuer |
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1013090489 | NPI | - | NPPES |
Provider Name | Deanna M Ecklund |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1396160628 PECOS PAC ID: 0042618001 Enrollment ID: I20211006001771 |
Provider Name | Troy D Reiner |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1225352784 PECOS PAC ID: 0840697355 Enrollment ID: I20240213000194 |