Provider Demographics
NPI:1730675232
Name:KARUNA CENTER LLC
Entity Type:Organization
Organization Name:KARUNA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PFANNENSTIEL
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:786-556-7599
Mailing Address - Street 1:841 1/2 MASSACHUSETTS ST STE D
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2673
Mailing Address - Country:US
Mailing Address - Phone:786-556-7599
Mailing Address - Fax:
Practice Address - Street 1:841 1/2 MASSACHUSETTS ST STE D
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2673
Practice Address - Country:US
Practice Address - Phone:786-556-7599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-08
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9496104100000X
KS42591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty