Organization
CHAUTAUQUA COUNSELING CENER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS D HOLTGREWE LCPC (PROGRAM DIRECTOR)
(913) 645-6652
Entity
Organization
Contact information
Practice address
5960 DEARBORN ST, SUITE 1, MISSION, KS 66202-3316
(913) 362-6614
(913) 362-6614
Mailing address
5960 DEARBORN ST, SUITE 1, MISSION, KS 66202-3316
(913) 362-6614
(913) 362-6614
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
530
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32788013
BLUE CROSS BLUE SHIELD
MO
Enumeration date
05/05/2007
Last updated
08/22/2020
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