Provider Demographics
NPI:1568865848
Name:THALIA HOUSE
Entity Type:Organization
Organization Name:THALIA HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:913-307-6407
Mailing Address - Street 1:5301 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2647
Mailing Address - Country:US
Mailing Address - Phone:888-913-1428
Mailing Address - Fax:
Practice Address - Street 1:10875 W 192ND PL
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-7527
Practice Address - Country:US
Practice Address - Phone:913-307-6407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness