Provider Demographics
NPI:1710704523
Name:PANACEA GROUP LLC
Entity type:Organization
Organization Name:PANACEA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:913-568-1013
Mailing Address - Street 1:4939 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1766
Mailing Address - Country:US
Mailing Address - Phone:913-568-1013
Mailing Address - Fax:816-548-1036
Practice Address - Street 1:8500 SHAWNEE MISSION PKWY STE L14
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66202-2967
Practice Address - Country:US
Practice Address - Phone:816-867-0306
Practice Address - Fax:816-548-1036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty