Organization
INDIVIDUAL EXPRESSIONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R FORTIN (PRESIDENT)
(816) 509-5509
Entity
Organization
Contact information
Practice address
507 SE 3RD ST, LEES SUMMIT, MO 64063-2810
(816) 524-4745
(816) 524-4751
Mailing address
8317 WOODSON DR, RAYTOWN, MO 64138-3550
(816) 356-3659
(816) 356-1207
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/05/2007
Last updated
08/22/2020
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