Iroquois Center for Human Development, Inc.
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Greensburg, KS
NPI 1710095435 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1710095435
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- Legal business name
- IROQUOIS CENTER FOR HUMAN DEVELOPMENT, INC.
- Practice address
- 610 E Grant Ave
Greensburg, KS 67054-2708 - Phone
- (620) 723-2272
- Fax
- (620) 723-2272
- NPI assigned
- Aug 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Charles Sheldon Carpenter, LMLP, LCP
- Title
- Executive Director
- Phone
- (620) 723-2272
Practitioners 11
-
Julia Butler, LCPC
-
Tracy Jo Caldwell, RN, APRN
-
Angela D Kooken, LMSW
-
Kurt D Leis, ARNP
-
Aaron Pendergrass, LSCSW
-
Scott G Rogers, LMLP, LCP
-
Stephanie J Salisbury, LSCSW
-
Charles Lucas Stephens, LMLP, LCP
-
Cheryl R Gore, APRN
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | Yes |
Addresses
Primary practice location
610 E Grant Ave
Greensburg, KS 67054-2708
Mailing address
610 E Grant Ave
Greensburg, KS 67054-2708
Phone (620) 723-2272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100098110A | Medicaid | KS | |
| 6916 | Other | KS | BCBS |
| 10098110B | Medicaid | KS |
Other providers in Greensburg, KS
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- Iroquois Center for Human Development, Inc.
- Iroquois Center for Human Development, Inc.
- Kansas Assisted Living LLC
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All providers in Greensburg, KS · Emotionally Disturbed Childrens' Residential Treatment Facility in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.