# BOMBADIL BEHAVIORAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871454140
- **Authorized official:** JENNIFER GILLENWATER LMSW, LAC (THERAPIST)
- **Authorized official phone:** (620) 366-9444

## Contact information

- **Practice address:** 128 S CONSTITUTION ST, EMPORIA, KS 66801-4621
- **Practice address phone:** (620) 366-9444
- **Mailing address:** 128 S CONSTITUTION ST, EMPORIA, KS 66801-4621
- **Mailing address phone:** (620) 366-9444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2025
- **Last updated:** 11/18/2025