| Sophia Center, Llc | |
|
102 Olive St Lansing KS 66043-1639 | |
| (913) 651-2674 | |
| (866) 565-4853 |
| Full Name | Sophia Center, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 102 Olive St, Lansing, Kansas |
| Authorized Official Name and Position | Deborah Sue Shaddy (PRESIDENT) |
| Authorized Official Contact | 9136512674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sophia Center, Llc 520 Santa Fe St Leavenworth KS 66048-4444 Ph: (913) 651-2674 | Sophia Center, Llc 102 Olive St Lansing KS 66043-1639 Ph: (913) 651-2674 |
| NPI Number | 1992016760 |
|---|---|
| Provider Enumeration Date | 06/28/2010 |
| Last Update Date | 06/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992016760 | NPI | - | NPPES |
| 46082363726 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 358 (Kansas) | Primary |
Yandura Therapy Sevices Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 961 Clearview Dr, Lansing, KS 66043 Phone: 913-680-3333 |