MATRIX CENTER (ADDICTIVE BEHAVIORAL CHANGE HEALTH GROUP) NPI 1003043639

Clinic/Center (Rehabilitation, Substance Use Disorder) in Wichita, KS

NPI 1003043639 Organization Clinic/Center Rehabilitation, Substance Use Disorder

About MATRIX CENTER (ADDICTIVE BEHAVIORAL CHANGE HEALTH GROUP)

Matrix Center (addictive Behavioral Change Health Group) is a provider established in Wichita, Kansas specializing in clinic/center (rehabilitation, substance use disorder) . The NPI number of Matrix Center (addictive Behavioral Change Health Group) is 1003043639 and was assigned on June 2009. The practitioner's primary taxonomy code is 261QR0405X with license number 07080895 (KS). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Matrix Center. The authorized official of this NPI record is Mr. Steve Goko Kamau B.a,cadc1 (Ceo)

NPI

1003043639

Provider NameMATRIX CENTER (ADDICTIVE BEHAVIORAL CHANGE HEALTH GROUP)
Provider Location Address9918 E HARRY ST WICHITA, KS 67207
Provider Mailing Address9918 E HARRY ST WICHITA, KS 67207
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameMATRIX CENTER
Other Name TypeDoing Business As (3)
Enumeration Date06-22-2009
Last Update Date06-22-2009


Primary Taxonomy

Taxonomy Code261QR0405X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRehabilitation, Substance Use Disorder
License No.07080895
License StateKS

Business Address

MATRIX CENTER
9918 E HARRY ST
WICHITA, KS
ZIP 67207
Phone: (316) 765-2764
Fax: (316) 689-8285

Get Directions


Mailing Address

MATRIX CENTER
9918 E HARRY ST
WICHITA, KS
ZIP 67207
Phone: (316) 765-2764
Fax: (316) 689-8285



Authorized Official

Authorized Official NameMR. STEVE GOKO KAMAU B.A,CADC1
Authorized Official TitleCEO
Authorized Official Phone(316) 765-2764

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1578712600MR. STEPHEN KAMAU MA, LCAC
Individual
Counselor (Addiction (Substance Use Disorder))9918 E HARRY ST
WICHITA, KS 67207
(316) 260-3445

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.