Basic Information
Provider Information
NPI: 1326548710
EntityType: 2
ReplacementNPI:  
OrganizationName: OLATHE HEALTH PHYSICIANS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BEHAVIORAL HEALTH PROFESSIONALS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20333 W 151ST ST
Address2:  
City: OLATHE
State: KS
PostalCode: 660615350
CountryCode: US
TelephoneNumber: 9137914461
FaxNumber: 9133248656
Practice Location
Address1: 20333 W 151ST ST
Address2:  
City: OLATHE
State: KS
PostalCode: 660615350
CountryCode: US
TelephoneNumber: 9137914461
FaxNumber: 9133248656
Other Information
ProviderEnumerationDate: 02/13/2018
LastUpdateDate: 02/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WIENS
AuthorizedOfficialFirstName: CATHERINE
AuthorizedOfficialMiddleName: R.
AuthorizedOfficialTitleorPosition: VP/QUALITY & COMPLIANCE
AuthorizedOfficialTelephone: 9137914459
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: OLATHE HEALTH PHYSICIANS, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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