Organization
SEQUEL OF KANSAS, LLC
Active
Other names
Lakeside Academy of Kansas
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CAUDLE (SENIOR DIRECTOR OF PATIENT ACCOUNTS)
(256) 880-3339
Entity
Organization
Contact information
Practice address
24401 W MACARTHUR RD, GODDARD, KS 67052-8713
(316) 794-2760
(316) 794-2773
Mailing address
24401 W MACARTHUR RD, P.O. BOX 429, GODDARD, KS 67052-8713
(316) 794-2760
(316) 794-2773
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
0063040-008
KS
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/26/2013
Last updated
09/10/2021
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