Organization
AT PROVIDER GROUP OF KANSAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE MULLINGS (DIRECTOR OF COMPLIANCE)
(834) 769-8758
Entity
Organization
Contact information
Practice address
9393 W 110TH ST STE 500, OVERLAND PARK, KS 66210-1464
(845) 769-8758
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(845) 769-8758
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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