Provider Demographics
NPI:1164831418
Name:SUNFLOWER WELLNESS RETREAT
Entity Type:Organization
Organization Name:SUNFLOWER WELLNESS RETREAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-481-9389
Mailing Address - Street 1:29875 W 339TH ST
Mailing Address - Street 2:
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-4159
Mailing Address - Country:US
Mailing Address - Phone:913-481-9389
Mailing Address - Fax:
Practice Address - Street 1:29875 W 339TH ST
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-4159
Practice Address - Country:US
Practice Address - Phone:913-481-9389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS001Y003D101YA0400X, 276400000X, 283X00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No276400000XHospital UnitsRehabilitation, Substance Use Disorder UnitGroup - Single Specialty
No283X00000XHospitalsRehabilitation Hospital