Organization
KANSAS CITY COMMUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EUGENE MORGAN M.S. M.P.A. (PRESIDENT)
(816) 421-6670
Entity
Organization
Contact information
Practice address
622 BENTON BLVD, KANSAS CITY, MO 64124-2559
(816) 421-6670
(816) 842-1835
Mailing address
1730 PROSPECT AVE, KANSAS CITY, MO 64127-2544
(816) 421-6670
(816) 421-4701
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053587469
—
MO
Enumeration date
04/08/2010
Last updated
04/08/2010
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