Basic Information
| Provider Information | |||||||||
| NPI: | 1215058581 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT FRANCIS COMMUNITY AND RESIDENTIAL SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 509 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674012353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858250541 | ||||||||
| FaxNumber: | 7852850062 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 E IRON AVE | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674012634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858250541 | ||||||||
| FaxNumber: | 7858250062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2007 | ||||||||
| LastUpdateDate: | 12/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | PATRICK | ||||||||
| AuthorizedOfficialFirstName: | KRISTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER OF ACCOUNTING SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 7858250541 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
ID Information
| ID | Type | State | Issuer | Description | 100005020K | 05 | KS | MEDICAID | 100005020L | 05 | KS | MEDICAID |