Organization
COMMUNITY ACCESS
Active
Other names
LS Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY LYNNE TAULA (OFFICE MANAGER)
(816) 257-7222
Entity
Organization
Contact information
Practice address
1402 S LEES SUMMIT RD, INDEPENDENCE, MO 64050-4117
(816) 257-7222
(816) 257-7188
Mailing address
1814 N WHITNEY RD, INDEPENDENCE, MO 64058-1574
(816) 257-7222
(816) 257-7188
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
8000787
MO
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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