Organization
SOUTHEAST KANSAS MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA BENNETT (DIRECTOR OF OFFICE OPERATIONS)
(620) 365-8641
Entity
Organization
Contact information
Practice address
1106 S 9TH ST, HUMBOLDT, KS 66748-1934
(620) 473-2241
(620) 473-3334
Mailing address
1106 S 9TH ST, HUMBOLDT, KS 66748-1934
(620) 473-2241
(620) 473-3334
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006901
BLUE SHIELD
KS
05
—
100098050D
—
KS
Enumeration date
02/12/2007
Last updated
05/03/2024
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