Organization
HEALTHCORE CLINIC INC
Active
Other names
Center for Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA LOVELADY (CEO)
(316) 691-0249
Entity
Organization
Contact information
Practice address
2707 EAST 21ST STREET NORTH, WICHITA, KS 67214-2249
(316) 691-0249
(316) 691-9939
Mailing address
2707 EAST 21ST STREET NORTH, WICHITA, KS 67214-2249
(316) 691-0249
(316) 691-9939
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1033218565
KS
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
07000887
KS
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
07000882
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100321990
—
KS
05
—
100321990A
—
KS
05
—
100321990C
—
KS
Enumeration date
09/21/2006
Last updated
08/14/2015
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