Provider Demographics
NPI:1114433059
Name:KANSAS FAMILY ADVISORY NETWORK INC
Entity Type:Organization
Organization Name:KANSAS FAMILY ADVISORY NETWORK INC
Other - Org Name:KANSAS FAMILY ADVISORY NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:ADRIENNE
Authorized Official - Last Name:SHAW-WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:316-529-9137
Mailing Address - Street 1:PO BOX 8577
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0577
Mailing Address - Country:US
Mailing Address - Phone:316-529-9137
Mailing Address - Fax:316-529-9110
Practice Address - Street 1:333 E ENGLISH ST STE 250
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-4315
Practice Address - Country:US
Practice Address - Phone:316-529-9137
Practice Address - Fax:316-529-9137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency