Organization
CENTER FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY F LAKIN D.O (OWNER)
(316) 201-1234
Entity
Organization
Contact information
Practice address
1333 N BROADWAY ST, SUITE C, WICHITA, KS 67214-2894
(316) 201-1234
(866) 316-4467
Mailing address
PO BOX 250, MAIZE, KS 67101-0250
(316) 722-2448
(866) 316-4467
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
KS
Other
Enumeration date
07/03/2009
Last updated
07/03/2009
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