Provider Demographics
NPI:1679341051
Name:KJM VENTURES INC
Entity type:Organization
Organization Name:KJM VENTURES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:316-204-6484
Mailing Address - Street 1:1349 N ARGONIA RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:KS
Mailing Address - Zip Code:67106-8012
Mailing Address - Country:US
Mailing Address - Phone:316-204-6484
Mailing Address - Fax:
Practice Address - Street 1:7926 W 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1742
Practice Address - Country:US
Practice Address - Phone:316-272-5502
Practice Address - Fax:316-462-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health