Provider Demographics
NPI:1326381328
Name:ROAD TO RECOVERY - LAWRENCE LLC
Entity Type:Organization
Organization Name:ROAD TO RECOVERY - LAWRENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:AHRENS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, LCAC
Authorized Official - Phone:316-201-1676
Mailing Address - Street 1:1333 N BROADWAY ST STE E
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2894
Mailing Address - Country:US
Mailing Address - Phone:316-201-1676
Mailing Address - Fax:316-201-1762
Practice Address - Street 1:1333 N BROADWAY ST STE E
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2894
Practice Address - Country:US
Practice Address - Phone:316-201-1676
Practice Address - Fax:316-201-1762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS261QM0801XMedicaid