Kelley Detention Services of Wakeeney, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

0033863-001 Issued in KS

Legal business name

KELLEY DETENTION SERVICES OF WAKEENEY, INC.

Doing business as

Trego County Secure Care Center

Practice address

675 South 13TH Street
Wakeeney, KS 67672

Phone

(785) 743-5378

Fax

(785) 743-5245

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terry L. Campbell

Title

Vice-President - Coo

Phone

(785) 232-7445

Specialties & licenses 1

Addresses

Other names 1

• Trego County Secure Care Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104042290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 FLINT ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662143333",
            "telephone_number": "913-647-7732",
            "fax_number": "913-647-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SOUTH 13TH STREET",
            "city": "WAKEENEY",
            "state": "KS",
            "postal_code": "67672",
            "telephone_number": "785-743-5378",
            "fax_number": "785-743-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY DETENTION SERVICES OF WAKEENEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE-PRESIDENT - COO",
        "authorized_official_telephone_number": "785-232-7445"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "KS",
            "license": "0033863-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trego County Secure Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Wakeeney, KS
• Providers in Wakeeney, KS by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.