Organization
NEW CHANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DERISE UNRUH CDAC II NCACII AAP (EXECUTIVE DIRECTOR)
(620) 225-0476
Entity
Organization
Contact information
Practice address
2500 E WYATT EARP BLVD, DODGE CITY, KS 67801-7037
(620) 225-0476
(620) 225-0433
Mailing address
2500 E WYATT EARP BLVD, DODGE CITY, KS 67801-7037
(620) 225-0476
(620) 225-0433
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
068
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004998
BLUE CROSS BLUE SHIELD
KS
Enumeration date
07/07/2006
Last updated
08/22/2020
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