Basic Information
| Provider Information | |||||||||
| NPI: | 1265785232 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTH PARTNERSHIP CLINIC, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 S CLAIRBORNE RD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136482266 | ||||||||
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| Practice Location | |||||||||
| Address1: | 407 S CLAIRBORNE RD | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136482266 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2012 | ||||||||
| LastUpdateDate: | 03/23/2021 | ||||||||
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| AuthorizedOfficialLastName: | FALK | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9136482266 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
ID Information
| ID | Type | State | Issuer | Description | 200852450B | 05 | KS | MEDICAID |