# KCMOSD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770608135
- **Authorized official:** KCMO SD (CLINIC)
- **Authorized official phone:** (816) 418-8653

## Contact information

- **Practice address:** 3221 INDIANA AVE, KANSAS CITY, MO 64128-2062
- **Practice address phone:** (816) 418-2075
- **Mailing address:** 1215 E TRUMAN RD, KANSAS CITY, MO 64106-3152
- **Mailing address phone:** (816) 418-8653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 08/22/2020