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Community Health Center of Southeast Kansas, Inc.

Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Fort Scott, KS

NPI 1003499708 · NPPES record last updated Dec 30, 2024

Key facts

NPI
1003499708
Entity type
Organization (NPI type 2)
Primary specialty
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name
COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Practice address
2322 S Main St
Fort Scott, KS 66701-3026
Phone
(620) 223-8040
NPI assigned
Apr 30, 2021
Organization subpart
No

Authorized official

Name
Daniel Spencer Creitz, JD
Title
Senior VP, Chief Compliance Officer
Phone
(620) 240-5015

Corporate family (same tax ID) 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

National Provider Directory

Tax ID family
Community Health Center of Southeast Kanas Inc (43 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Yes

Addresses

Primary practice location

2322 S Main St
Fort Scott, KS 66701-3026

Mailing address

PO Box 1832
Pittsburg, KS 66762-1832

Other identifiers

IdentifierTypeStateIssuer
30003958250054MedicaidKS
KDADS033021HOtherKSSUBSTANCE USE AND ADDICTIONS SERVICES CERTIFICATE

Other providers in Fort Scott, KS

All providers in Fort Scott, KS · Substance Use Disorder Rehabilitation Clinic/Center in Kansas

Sources for this page

Verify at the official NPI Registry.