Provider Demographics
NPI:1801208053
Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC
Other - Org Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS/FOUR COUNTY MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:K
Authorized Official - Last Name:POSTAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-231-9873
Mailing Address - Street 1:3011 N MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-2546
Mailing Address - Country:US
Mailing Address - Phone:620-231-9873
Mailing Address - Fax:620-231-2808
Practice Address - Street 1:3354 HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-7841
Practice Address - Country:US
Practice Address - Phone:620-231-1748
Practice Address - Fax:620-332-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)