Provider Demographics
NPI:1184595993
Name:ADVANCED BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-214-0372
Mailing Address - Street 1:828 N REDBUD CT
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-3207
Mailing Address - Country:US
Mailing Address - Phone:316-214-0372
Mailing Address - Fax:
Practice Address - Street 1:555 N WOODLAWN ST STE 120
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3678
Practice Address - Country:US
Practice Address - Phone:316-214-0372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty