Organization
PRAIRIE VILLAGE BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM WEAVER (BILLING MANAGER)
(785) 266-0031
Entity
Organization
Contact information
Practice address
26431 W 109TH TER, OLATHE, KS 66061-8779
(785) 266-0031
(785) 266-4225
Mailing address
PO BOX 3905, LAWRENCE, KS 66046-0905
(785) 266-0031
(785) 266-4225
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0294
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119010
BCBS OF KANSAS
KS
01
—
25212023
BCBS OF KANSAS CITY
MO
Enumeration date
07/15/2008
Last updated
12/10/2012
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