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Elizabeth Layton Center, Inc.

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Ottawa, KS

NPI 1649296757 · NPPES record last updated Aug 17, 2016

Key facts

NPI
1649296757
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
License
008 (KS)
Legal business name
ELIZABETH LAYTON CENTER, INC.
Practice address
2537 Eisenhower Rd
Ottawa, KS 66067-9482
Phone
(785) 242-3780
Fax
(785) 242-6397
NPI assigned
Jul 14, 2006
Organization subpart
No

Authorized official

Name
Leslie Bjork, PSYD, LP NPI 1508926130
Title
Executive Director
Phone
(785) 242-3780

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 1

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

Practitioners 122

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 122

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040209000253 KS Part B Supplier - Clinic/Group Practice 1557255940 Receives reassigned benefits from 41 practitioners
Practice locations: Ottawa, KS; Paola, KS

National Provider Directory

Tax ID family
Franklin Co MHC Inc (2 organizations share this tax ID)

Locations

1418 S Main St
Ste 3
Ottawa, KS 66067
Phone (785) 242-3780

2537 Eisenhower Rd
Ottawa, KS 66067
Phone (785) 242-2183

204 E 15th St
Ottawa, KS 66067
Phone (785) 242-2183

102 Baptiste Dr
Paola, KS 66071
Phone (913) 557-9096

25955 W 327th St
Paola, KS 66071
Phone (913) 557-9096

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 008 KS Yes

Addresses

Primary practice location

2537 Eisenhower Rd
Ottawa, KS 66067-9482

Mailing address

2537 Eisenhower Rd
PO Box 677
Ottawa, KS 66067-9482
Phone (785) 242-3780

Other identifiers

IdentifierTypeStateIssuer
100097990AMedicaidKS

Other names

  • Franklin County Mental Health Clinic, Inc. Former legal business name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 17, 2016.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1649296757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 EISENHOWER RD",
            "address_2": "PO BOX 677",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660679482",
            "telephone_number": "785-242-3780",
            "fax_number": "785-242-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 EISENHOWER RD",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660679482",
            "telephone_number": "785-242-3780",
            "fax_number": "785-242-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH LAYTON CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "BJORK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "785-242-3780",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "KS",
            "license": "008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097990A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franklin County Mental Health Clinic, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ottawa, KS

All providers in Ottawa, KS · Mental Health Clinic/Center (Including Community Mental Health Center) in Kansas

Sources for this page

Verify at the official NPI Registry.