Provider Demographics
NPI:1174513444
Name:JOHNSON COUNTY MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:JOHNSON COUNTY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY IMPROVEMENT REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-826-4200
Mailing Address - Street 1:6000 LAMAR AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3234
Mailing Address - Country:US
Mailing Address - Phone:913-826-4200
Mailing Address - Fax:913-715-2533
Practice Address - Street 1:6000 LAMAR AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3234
Practice Address - Country:US
Practice Address - Phone:913-826-4200
Practice Address - Fax:913-715-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2920000COtherMEDICARE PTAN
KS30003914730013Medicaid
KS2920000BOtherMEDICARE PTAN
KS30003914730011Medicaid
KS30003914730015Medicaid
KS30003914730021Medicaid
KS100098010JMedicaid
KS30003914730001Medicaid
KS2920000AOtherMEDICARE PTAN
KS30003914730012Medicaid
KS100098010FMedicaid
KS100098010DMedicaid