Organization
FOUR COUNTY MENTAL HEALTH CENTER
Active
Other names
Active Partners In Home Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG HENNEN (EXECUTIVE DIRECTOR)
(620) 331-1748
Entity
Organization
Contact information
Practice address
415 FRUITLAND, INDEPENDENCE, KS 67301
(620) 332-8584
Mailing address
PO BOX 688, INDEPENDENCE, KS 67301-0688
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
A103009
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097980U
—
KS
Enumeration date
03/15/2010
Last updated
11/11/2011
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