1952871352 NPI number — BARIATRIC EATING DISORDERS SOLUTIONS, LLC

Table of content: (NPI 1952871352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952871352 NPI number — BARIATRIC EATING DISORDERS SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARIATRIC EATING DISORDERS SOLUTIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952871352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23351 PRAIRIE STAR PKWY STE A275
Provider Second Line Business Mailing Address:
23351 PRAIRIE STAR PARKWAY SUITE A275
Provider Business Mailing Address City Name:
LENEXA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66227-6201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-676-8620
Provider Business Mailing Address Fax Number:
913-676-8670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23351 PRAIRIE STAR PARKWAY
Provider Second Line Business Practice Location Address:
SUITE A275
Provider Business Practice Location Address City Name:
LENEXA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-676-8620
Provider Business Practice Location Address Fax Number:
913-676-8670
Provider Enumeration Date:
11/28/2018

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
KATHI
Authorized Official Middle Name:
JO
Authorized Official Title or Position:
OWNER/THERAPIST
Authorized Official Telephone Number:
913-676-8620

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com