Provider Demographics
NPI:1982642583
Name:SMOKY HILL FOUNDATION FOR CHEMICAL DEPENDENCY, INC.
Entity Type:Organization
Organization Name:SMOKY HILL FOUNDATION FOR CHEMICAL DEPENDENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:UKELE
Authorized Official - Suffix:
Authorized Official - Credentials:BA, AAPS
Authorized Official - Phone:785-625-5521
Mailing Address - Street 1:2714 PLAZA AVE
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1912
Mailing Address - Country:US
Mailing Address - Phone:785-625-5521
Mailing Address - Fax:
Practice Address - Street 1:2714 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1912
Practice Address - Country:US
Practice Address - Phone:785-625-5521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSSM004980OtherBLUE CROSS/BLUE SHIELD
KS100328020AMedicaid