Provider Demographics
NPI:1467491340
Name:CENTRAL KANSAS MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:CENTRAL KANSAS MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLENNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:785-823-6322
Mailing Address - Street 1:809 ELMHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7405
Mailing Address - Country:US
Mailing Address - Phone:785-823-6322
Mailing Address - Fax:785-823-3109
Practice Address - Street 1:809 ELMHURST BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7405
Practice Address - Country:US
Practice Address - Phone:785-823-6322
Practice Address - Fax:785-823-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100097970AMedicaid
KSCG4715OtherRAILROAD MEDICARE
KS006933OtherBLUE CROSS GROUP NUMBER
KSCG4715OtherRAILROAD MEDICARE