Provider Demographics
NPI:1427051242
Name:BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRNE-LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS RAODAC
Authorized Official - Phone:316-660-7411
Mailing Address - Street 1:714 S HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-3002
Mailing Address - Country:US
Mailing Address - Phone:316-660-7411
Mailing Address - Fax:316-651-5901
Practice Address - Street 1:714 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-3002
Practice Address - Country:US
Practice Address - Phone:316-660-7411
Practice Address - Fax:316-651-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS050251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS116065OtherBCBS