Provider Demographics
NPI:1306545926
Name:SOUTH WIND PSYCHIATRY LLC
Entity type:Organization
Organization Name:SOUTH WIND PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF STRATEGIC INITIATIVES
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MALTESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-355-3299
Mailing Address - Street 1:9393 W 110TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1464
Mailing Address - Country:US
Mailing Address - Phone:913-359-5611
Mailing Address - Fax:720-367-5067
Practice Address - Street 1:9393 W 110TH ST STE 500
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1464
Practice Address - Country:US
Practice Address - Phone:913-359-5611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty