# PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Leavenworth Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972389344
- **Authorized official:** CHRISTOPHER DOAN (MANAGING ASSOCIATE GENERAL COUNSEL)
- **Authorized official phone:** (310) 259-4706

## Contact information

- **Practice address:** 3550 S 4TH ST, LEAVENWORTH, KS 66048-5071
- **Practice address phone:** (913) 680-6442
- **Mailing address:** 3550 S 4TH ST, LEAVENWORTH, KS 66048-5071
- **Mailing address phone:** (913) 680-6442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/01/2023
- **Last updated:** 09/01/2023