Provider Demographics
NPI:1730906868
Name:SILVER ARROW PSYCHIATRIC CARE OF KANSAS - LLC
Entity type:Organization
Organization Name:SILVER ARROW PSYCHIATRIC CARE OF KANSAS - LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOCKLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MEMBER
Authorized Official - Phone:740-207-6574
Mailing Address - Street 1:2905 W 146TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-5918
Mailing Address - Country:US
Mailing Address - Phone:740-207-6574
Mailing Address - Fax:
Practice Address - Street 1:5251 W 116TH PL STE 200
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-2011
Practice Address - Country:US
Practice Address - Phone:913-420-2160
Practice Address - Fax:816-817-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty