Provider Demographics
NPI:1265439871
Name:EMBERHOPE, INC
Entity type:Organization
Organization Name:EMBERHOPE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICKAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-202-4989
Mailing Address - Street 1:PO BOX 210
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0210
Mailing Address - Country:US
Mailing Address - Phone:316-283-1950
Mailing Address - Fax:316-529-9351
Practice Address - Street 1:900 W BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-2037
Practice Address - Country:US
Practice Address - Phone:316-283-1950
Practice Address - Fax:316-529-9351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 1041C0700X, 106H00000X, 2084N0400X, 323P00000X, 320700000X
KS0015391-001251B00000X
KS0003255-002251B00000X
KS251K00000X, 251S00000X, 251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility