Provider Demographics
NPI:1588848352
Name:CAH ACQUISITION COMPANY 3 LLC
Entity Type:Organization
Organization Name:CAH ACQUISITION COMPANY 3 LLC
Other - Org Name:ESTHER BECKER CENTER FOR HEALTH AND WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-486-2642
Mailing Address - Street 1:1100 MAIN ST
Mailing Address - Street 2:SUITE 2350
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-2120
Mailing Address - Country:US
Mailing Address - Phone:785-486-2642
Mailing Address - Fax:785-486-2842
Practice Address - Street 1:517 MAIN ST
Practice Address - Street 2:
Practice Address - City:EVEREST
Practice Address - State:KS
Practice Address - Zip Code:66424-9157
Practice Address - Country:US
Practice Address - Phone:785-548-7610
Practice Address - Fax:785-486-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-007-002207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100069780CMedicaid
KS110054OtherBLUE SHIELD