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Organization

SPIRITS HEALING SOULS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA L MAYFIELD (OWNER)
(316) 641-4403
Entity
Organization

Contact information

Practice address
1880 SE COLE CREEK RD, EL DORADO, KS 67042-9109
(316) 641-4403
Mailing address
1880 SE COLE CREEK RD, EL DORADO, KS 67042-9109
(316) 641-4403

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
171000000X
COMMUNITY MENTAL HEALTH CENTER
KS
01
172V00000X
COMMUNITY MENTAL HEALTH CENTER
KS
Enumeration date
09/27/2016
Last updated
10/06/2016
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