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.

Practice address

675 South 13TH Street
Wakeeney, KS 67672

Phone

(785) 743-5378

Fax

(785) 743-5245

NPI assigned

Apr 17, 2007

Organization subpart

No

Name

Terry L. Campbell

Title

Vice-President - Coo

Phone

(785) 232-7445

• Trego County Secure Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "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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• All providers in Wakeeney, KS
• 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.