Provider Demographics
NPI:1952007536
Name:MILEHAM PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:MILEHAM PSYCHIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILEHAM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-648-6171
Mailing Address - Street 1:1660 N TYLER RD STE A
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-4918
Mailing Address - Country:US
Mailing Address - Phone:316-779-3873
Mailing Address - Fax:316-425-5558
Practice Address - Street 1:1660 N TYLER RD STE A
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4918
Practice Address - Country:US
Practice Address - Phone:316-779-3873
Practice Address - Fax:316-425-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)