Provider Demographics
NPI:1700408119
Name:SCRAPPY ENTERPRISES, INC
Entity Type:Organization
Organization Name:SCRAPPY ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LMAC
Authorized Official - Phone:316-759-9136
Mailing Address - Street 1:300 W DOUGLAS AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2904
Mailing Address - Country:US
Mailing Address - Phone:316-759-9136
Mailing Address - Fax:316-500-7862
Practice Address - Street 1:300 W DOUGLAS AVE STE 205
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2904
Practice Address - Country:US
Practice Address - Phone:316-759-9136
Practice Address - Fax:316-500-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder