COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.; NPI #1003499708

Contact Information

COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.

2322 S MAIN ST
FORT SCOTT, KS 66701-3026

Phone: 620-223-8040
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rehabilitation, Substance Use Disorder	261QR0405X
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.

NPI # 1003499708

LBN Legal business name COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.

Authorized official DANIEL CREITZ - (SENIOR VP, CHIEF COMPLIANCE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/30/2021

Last updated 12/30/2024 - More than a year ago

Identifiers

KS	Medicaid	30003958250054
KS	Other	KDADS033021H	SUBSTANCE USE AND ADDICTIONS SERVICES CERTIFICATE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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