Organization
ERAS MENTAL HEALTH RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA THEOBALD FNP (OWNER)
(316) 204-9258
Entity
Organization
Contact information
Practice address
11124 E 28TH ST N STE 105, WICHITA, KS 67226-4562
(316) 247-1065
(316) 462-5752
Mailing address
11124 E 28TH ST N STE 105, WICHITA, KS 67226-4562
(316) 247-1065
(316) 462-5752
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2026
Last updated
04/29/2026
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