Organization
FELON WOMEN 4 CHANGE, INCORPORATED
Active
Other names
FW4C
Organization subpart
No
Provider details
NPI number
Authorized official
ALEISHA J FRAZIER (DIRECTOR)
(816) 922-9081
Entity
Organization
Contact information
Practice address
1468 E 77TH STREET, KANSAS CITY, MO 64131
(816) 922-9081
Mailing address
4134 PROSPECT AVE, KANSAS CITY, MO 64130-1323
(816) 922-9081
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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