Provider Demographics
NPI:1255817664
Name:AETNA BETTER HEALTH OF KANSAS INC.
Entity type:Organization
Organization Name:AETNA BETTER HEALTH OF KANSAS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER-GOUGE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:913-202-5293
Mailing Address - Street 1:9401 INDIAN CREEK PKWY STE 1300
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2021
Mailing Address - Country:US
Mailing Address - Phone:913-202-5293
Mailing Address - Fax:
Practice Address - Street 1:9401 INDIAN CREEK PKWY STE 1300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2021
Practice Address - Country:US
Practice Address - Phone:913-202-5293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AETNA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization