Organization
IROQUOIS CENTER FOR HUMAN DEVELOPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES SHELDON CARPENTER LMLP, LCP (EXECUTIVE DIRECTOR)
(620) 723-2272
Entity
Organization
Contact information
Practice address
610 E GRANT AVE, GREENSBURG, KS 67054-2708
(620) 723-2272
(620) 723-2272
Mailing address
610 E GRANT AVE, GREENSBURG, KS 67054-2708
(620) 723-2272
(620) 723-2272
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098110A
—
KS
05
—
10098110B
—
KS
01
—
6916
BCBS
KS
Enumeration date
08/25/2006
Last updated
08/22/2020
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