Organization
KANSAS NEUROLOGICAL INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT WIDICK (SUPERINTENDENT)
(785) 296-5301
Entity
Organization
Contact information
Practice address
3107 SW 21ST, TOPEKA, KS 66604-3245
(785) 296-5301
(785) 296-0707
Mailing address
3107 SW 21ST, TOPEKA, KS 66604-3245
(785) 296-5301
(785) 296-0707
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
363LF0000X
Family Nurse Practitioner
1353996081
KS
Other
Enumeration date
01/25/2007
Last updated
01/22/2019
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