Organization
INTERFACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA G ADAMS PHD (OWNER)
(816) 507-9943
Entity
Organization
Contact information
Practice address
235 E BROADWAY ST, EXCELSIOR SPRINGS, MO 64024-2564
(816) 507-9943
Mailing address
32302 W 231ST ST, LAWSON, MO 64062-8159
(816) 507-9943
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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