Organization
SUSAN WHITE
Active
Other names
Eagle Recovery Services & Consultation
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN GAYLE WHITE LMSW, CADCIII (EXECUTIVE DIRECTOR)
(913) 837-4919
Entity
Organization
Contact information
Practice address
5 S PEORIA ST, SUITE 206, LOUISBURG, KS 66053-4084
(913) 837-4919
(913) 837-4923
Mailing address
5 S PEORIA ST, SUITE 206, LOUISBURG, KS 66053-4084
(913) 837-4919
(913) 837-4923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
584
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200305900A
—
KS
Enumeration date
04/15/2007
Last updated
06/19/2008
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