CHANGING HABITS


Address: 1115 S Glendale St Ste 204, Parklane Shopping Center Lower Level, Wichita, KS 67218-3232
Phone: 3164095242

CHANGING HABITS (NPI# 1871833285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871833285
Entity Type Organization
Organization Name CHANGING HABITS
Practice Address 1115 S Glendale St Ste 204
Parklane Shopping Center Lower Level
Wichita
KS 67218-3232
Practice Telephone 3164095242
Practice Fax Number 3167192440
Mailing Telephone 3164095242
Mailing Fax Number 3167192440
Enumeration Date 2013-02-21
Last Update Date 2015-12-22
Authorized Official Name MR. DAVID BRIAN SIMMONS (OWNER)
Authorized Official Telephone 3164095242
Authorized Official Credential LAC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
07570128 KS Ambulatory Health Care Facilities

Office Location

Street Address 1115 S GLENDALE ST STE 204
PARKLANE SHOPPING CENTER LOWER LEVEL
City WICHITA
State KS
Zip Code 67218-3232

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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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Competitor

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City WICHITA
Zip Code 67218

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Dataset Information

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.

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