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Organization
SEQUEL OF KANSAS, LLC
Active
Organization
SEQUEL OF KANSAS, LLC
Active
Other names
Lakeside Academy of Kansas
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CAUDLE (SENIOR DIRECTOR OF PATIENT ACCOUNTS)
(256) 880-3339
Entity
Organization
Contact information
Practice address
24401 W MACARTHUR RD, GODDARD, KS 67052-8713
(316) 794-2760
(316) 794-2773
Mailing address
24401 W MACARTHUR RD, P.O. BOX 429, GODDARD, KS 67052-8713
(316) 794-2760
(316) 794-2773
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
0063040-008
KS
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/26/2013
Last updated
09/10/2021
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