Organization
SOUTHWEST GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE D BISSELL LP (EXECUTIVE DIRECTOR)
(620) 624-8171
Entity
Organization
Contact information
Practice address
333 W 15TH ST, LIBERAL, KS 67901-2455
(620) 624-8171
(620) 624-0114
Mailing address
PO BOX 2945, LIBERAL, KS 67905-2945
(620) 624-8171
(620) 624-0114
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098060A
—
KS
05
—
100098060B
—
KS
Enumeration date
09/13/2006
Last updated
12/18/2012
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