Provider Demographics
NPI:1346309333
Name:WYANDOT CENTER, INC.
Entity Type:Organization
Organization Name:WYANDOT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEVENBERGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-233-3300
Mailing Address - Street 1:757 ARMSTRONG AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101-2701
Mailing Address - Country:US
Mailing Address - Phone:913-233-3300
Mailing Address - Fax:
Practice Address - Street 1:757 ARMSTRONG AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-2701
Practice Address - Country:US
Practice Address - Phone:913-233-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2070251S00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS16291593-89Medicare ID - Type UnspecifiedCENTER'S NPI#