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Organization

MANDALA COMMUNITY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHELSEA JACKSON LMSW (OWNER & EXECUTIVE DIRECTOR)
(316) 734-5223
Entity
Organization

Contact information

Practice address
2637 FAIRMOUNT AVE, WICHITA, KS 67220-2410
(316) 734-5223
Mailing address
1302 FARMSTEAD ST, WICHITA, KS 67208-2629

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
05/02/2023
Last updated
05/02/2023
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