AVENUES FOR CHANGE; NPI #1114630076

Contact Information

AVENUES FOR CHANGE

809 S PATTON RD
GREAT BEND, KS 67530-4620

Phone: 620-796-2206
Fax: 866-288-1782
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Mental Health	101YM0800X

Indicates primary specialty

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NPI Profile & details for AVENUES FOR CHANGE

NPI #	`1114630076`
LBN Legal business name	AVENUES FOR CHANGE
Authorized official	KELLEY JOHNSON - (PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/05/2023
Last updated	04/14/2024 - About 2 years ago
Identifiers	n/a

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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AVENUES FOR CHANGE

Contact Information

Specialty

Mental Health

NPI Profile & details for AVENUES FOR CHANGE

Reviews for AVENUES FOR CHANGE