Organization
SAMUEL U. RODGERS HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT THEIS (ACTING CEO)
(816) 474-4920
Entity
Organization
Contact information
Practice address
2701 E 31ST ST, KANSAS CITY, MO 64128
(816) 861-7070
(816) 474-4914
Mailing address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 474-4914
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860859107
—
MO
05
—
866201304
—
MO
Enumeration date
04/03/2007
Last updated
06/07/2018
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