Organization
GROW HEALTHCARE GROUP OF KANSAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE COOPER (CHIEF EXECUTIVE OFFICER)
(347) 851-1139
Entity
Organization
Contact information
Practice address
801 E DOUGLAS AVE FL 2, WICHITA, KS 67202-3548
(316) 974-3161
Mailing address
801 E DOUGLAS AVE FL 2, WICHITA, KS 67202-3548
(316) 974-3161
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/10/2023
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