Provider Demographics
NPI:1902251655
Name:PRAIRIE VIEW, INC.
Entity Type:Organization
Organization Name:PRAIRIE VIEW, INC.
Other - Org Name:EAST WICHITA SUBSTANCE ABUSE INTENSIVE OUTPATIENT PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-284-6400
Mailing Address - Street 1:9333 E 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2927
Mailing Address - Country:US
Mailing Address - Phone:316-634-4700
Mailing Address - Fax:316-634-4770
Practice Address - Street 1:9333 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2927
Practice Address - Country:US
Practice Address - Phone:316-634-4700
Practice Address - Fax:316-634-4770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRAIRIE VIEW, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital