MARILLAC CENTER, INC. (NPI# 1750361119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750361119 |
| Entity Type | Organization |
| Organization Name | MARILLAC CENTER, INC. |
| Other Organization Name | MARILLAC |
| Practice Address |
8000 W 127th St Overland Park KS 66213-2714 |
| Practice Telephone | 8165083300 |
| Practice Fax Number | 8165083321 |
| Mailing Telephone | 8165083300 |
| Mailing Fax Number | 8165083321 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARK S RICHARDS (PRESIDENT CEO) |
| Authorized Official Telephone | 8165083300 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 0053702002 | KS | Residential Treatment Facilities |
| X | 323P00000X | Psychiatric Residential Treatment Facility | 0054352002 | KS | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Marillac | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790940591 | Marillac Center, Inc. | Clinic/Center | 8000 W 127th St, Overland Park, KS 66213-2714 | 2008-07-22 |
| 1003964875 | Marillac Center, Inc. | Psychiatric Hospital | 8000 W 127th St, Overland Park, KS 66213-2714 | 2007-01-08 |
| Street Address |
8000 W 127TH ST |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66213-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196174 | Dimas Omar Benitez | Behavior Technician | 8000 W 127th St, Overland Park, KS 66213-2714 | 2020-05-19 |
| 1497287783 | Jordan Pener | Counselor | 8000 W 127th St, Overland Park, KS 66213-2714 | 2017-03-28 |
| 1982141420 | Jason Southard | Social Worker | 8000 W 127th St, Overland Park, KS 66213-2714 | 2017-01-23 |
| 1982066759 | Britney Compton | Social Worker | 8000 W 127th St, Overland Park, KS 66213-2714 | 2016-03-22 |
| 1881088581 | Ashley Dugan | Social Worker | 8000 W 127th St, Overland Park, KS 66213-2714 | 2015-03-20 |
| 1942606280 | Katharine Olson | Counselor | 8000 W 127th St, Overland Park, KS 66213-2714 | 2014-11-14 |
| 1548680507 | Caitlin Mellencamp Winder | Psychiatry & Neurology | 8000 W 127th St, Overland Park, KS 66213-2714 | 2014-04-17 |
| 1023436862 | David Strother | Social Worker | 8000 W 127th St, Overland Park, KS 66213-2714 | 2014-03-30 |
| 1689001612 | Sharnee Garner | Social Worker | 8000 W 127th St, Overland Park, KS 66213-2714 | 2013-10-04 |
| 1588099808 | Maggie Chiu | Social Worker | 8000 W 127th St, Overland Park, KS 66213-2714 | 2013-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003345372 | Nicole Renee Oliphant | Speech-Language Pathologist | 12810 W 133 Pl Apt 3109, Overland Park, KS 66213 | 2017-06-08 |
| 1770026874 | Alyssa Potter | Physical Therapy Assistant | 12202 Goodman St, Overland Park, KS 66213 | 2016-11-22 |
| 1164809380 | Jessica Richter | Family Medicine | 10100 W 119th St Ste 150, Overland Park, KS 66213 | 2015-04-27 |
| 1891180816 | Naresh Kumar Dugal | Podiatrist | 13410 Westgate St Apt 2110, Overland Park, KS 66213 | 2015-04-06 |
| 1801219456 | Denise Ahnen | Lactation Consultant, Non-RN | 121300 Metcalf Ave, Overland Park, KS 66213 | 2014-01-31 |
| 1407294986 | Blue Valley Asc, P.a. | Clinic/Center | 12800 Metcalf Avenue Suite 2, Overland Park, KS 66213 | 2013-06-06 |
| 1023455326 | Duncan Arnold Killen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12542 W. 123rd Terr., Overland Park, KS 66213 | 2013-05-28 |
| 1821432345 | Seniorbridge Family Companies (mo), Inc. | In Home Supportive Care | 7304 W. 130th Street, Suite 100, Overland Park, KS 66213 | 2013-04-26 |
| 1538427273 | Charles E Emms D.c., Pa | Chiropractor | 11960 West 119th Street, 11960, Overland Park, KS 66213 | 2012-05-01 |
| 1194000570 | Phoenix Healthcare Clinic | Family Medicine | 11960 Quivira Road, Suite #100, Overland Park, KS 66213 | 2011-10-17 |
| Find all providers in zip 66213 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962789214 | Freedom House Ministries | Residential Treatment Facility, Emotionally Disturbed Children | 7044 Antioch Rd, Merriam, KS 66204-1246 | 2011-11-14 |
| 1104042290 | Kelley Detention Services of Wakeeney, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 675 South 13th Street, Wakeeney, KS 67672 | 2007-04-17 |
| 1669698759 | Clarence M. Kelley Detention Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 6700 Southwest Topeka Boulevard, Building 379, Forbes Field, Topeka, KS 66214 | 2007-04-17 |
| 1457576381 | Clarence M. Kelley Detention Services of Topeka, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2620 Se 23rd St, Topeka, KS 66605-1747 | 2007-04-16 |
| 1548316615 | The Salvation Army | Residential Treatment Facility, Emotionally Disturbed Children | 350 N Market St, Wichita, KS 67202-2010 | 2007-01-25 |
| 1932441177 | Riverside Academy | Residential Treatment Facility, Emotionally Disturbed Children | 2050 W 11th St N, Wichita, KS 67203-3006 | 2013-03-26 |
| 1871778217 | Richard Alspaw | Residential Treatment Facility, Emotionally Disturbed Children | 24401 W Macarthur Rd, Goddard, KS 67052-8713 | 2008-01-03 |
| 1184764151 | Kvc Hospitals Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2007-02-07 |
| 1235210196 | Area Mental Health Center | Residential Treatment Facility, Emotionally Disturbed Children | 1111 E Spruce St, Garden City, KS 67846-5958 | 2006-10-18 |
| 1154421097 | Southwest Guidance Center | Residential Treatment Facility, Emotionally Disturbed Children | 333 W 15th St, Liberal, KS 67901-2455 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
| City | OVERLAND PARK |
| Zip Code | 66213 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.