Organization
BLOOMING ROOTS THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINNE DAWN FULENWIDER LSCSW (OWNER)
(316) 223-4629
Entity
Organization
Contact information
Practice address
423 N MCLEAN BLVD, WICHITA, KS 67203-5964
(316) 223-4629
Mailing address
423 N MCLEAN BLVD, WICHITA, KS 67203-5964
(316) 223-4629
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
04/09/2026
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