Provider Demographics
NPI:1528284239
Name:JOHNSON COUNTY MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:JOHNSON COUNTY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:WIEBE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:913-831-2550
Mailing Address - Street 1:6000 LAMAR AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3234
Mailing Address - Country:US
Mailing Address - Phone:913-831-2550
Mailing Address - Fax:913-826-1589
Practice Address - Street 1:6000 LAMAR AVE
Practice Address - Street 2:STE 130
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3234
Practice Address - Country:US
Practice Address - Phone:913-831-2550
Practice Address - Fax:913-826-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)