Organization
SUBSTANCE ABUSE ASSESSMENT CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD CASEY BA-LAC (CEO)
(316) 267-3825
Entity
Organization
Contact information
Practice address
731 N WATER ST, STE 2, WICHITA, KS 67203-3853
(316) 267-3825
(316) 267-3843
Mailing address
731 N WATER ST, STE 4, WICHITA, KS 67203-3853
(316) 267-3825
(316) 267-3843
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100320580A
—
KS
Enumeration date
02/01/2007
Last updated
02/23/2012
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