Provider Demographics
NPI:1508233123
Name:ADDICTION RECOVERY COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:ADDICTION RECOVERY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC 473
Authorized Official - Phone:316-351-7138
Mailing Address - Street 1:120 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-1010
Mailing Address - Country:US
Mailing Address - Phone:316-351-7138
Mailing Address - Fax:316-295-4786
Practice Address - Street 1:120 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-1010
Practice Address - Country:US
Practice Address - Phone:316-351-7138
Practice Address - Fax:316-295-4786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS002H003S251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health