Provider Demographics
NPI:1588653588
Name:COWLEY COUNTY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:COWLEY COUNTY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-442-4540
Mailing Address - Street 1:22214 D ST
Mailing Address - Street 2:STROTHER FIELD
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-7376
Mailing Address - Country:US
Mailing Address - Phone:620-442-4540
Mailing Address - Fax:620-442-4559
Practice Address - Street 1:22214 D ST
Practice Address - Street 2:STROTHER FIELD
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-7376
Practice Address - Country:US
Practice Address - Phone:620-442-4540
Practice Address - Fax:620-442-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS005261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS006903OtherBCBS NUMBER
KS100098100CMedicaid
KS100098100DMedicaid
KS100098100AMedicaid
KS100098100EMedicaid
KS100363510AMedicaid
KS100098100AMedicaid