Provider Demographics
NPI:1043768286
Name:ZOE CENTER, LLC
Entity Type:Organization
Organization Name:ZOE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIKIARDOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-990-3002
Mailing Address - Street 1:215 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-1711
Mailing Address - Country:US
Mailing Address - Phone:316-530-2963
Mailing Address - Fax:
Practice Address - Street 1:215 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-1711
Practice Address - Country:US
Practice Address - Phone:316-530-2963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2633106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty