Organization
SUMMIT RANCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIA ESTES (BILLING AND CREDENTIALING MGR)
(208) 269-0689
Entity
Organization
Contact information
Practice address
18555 JOHNSON DR, SHAWNEE, KS 66217-8206
(913) 215-2438
(913) 424-2440
Mailing address
18555 JOHNSON DR STE 119, SHAWNEE, KS 66217-8206
(913) 215-2438
(913) 424-2440
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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