Provider Demographics
NPI:1609380401
Name:TURNER HOUSE CLINIC INC
Entity Type:Organization
Organization Name:TURNER HOUSE CLINIC INC
Other - Org Name:WYANDOTTE COMMUNITY HEALTH CENTER - TURNER HOUSE CHILDREN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-342-2552
Mailing Address - Street 1:21 N 12TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-5105
Mailing Address - Country:US
Mailing Address - Phone:913-342-2552
Mailing Address - Fax:
Practice Address - Street 1:21 N 12TH ST STE 300
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-5105
Practice Address - Country:US
Practice Address - Phone:913-342-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty