Provider Demographics
NPI:1619426517
Name:AFFILIATED HEALTH AND WELLNESS OUTPATIENT TREATMENT
Entity Type:Organization
Organization Name:AFFILIATED HEALTH AND WELLNESS OUTPATIENT TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:316-636-2888
Mailing Address - Street 1:1855 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3413
Mailing Address - Country:US
Mailing Address - Phone:316-636-2888
Mailing Address - Fax:316-636-2366
Practice Address - Street 1:1855 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3413
Practice Address - Country:US
Practice Address - Phone:316-636-2888
Practice Address - Fax:316-636-2366
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFILIATED FAMILY COUNSELORS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty