Organization
COMMUNITY SUPPORT PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY ROYER (OWNER)
(816) 777-1301
Entity
Organization
Contact information
Practice address
8959 E. 59TH STREET, RAYTOWN, MO 64133-3709
(816) 777-1301
(816) 777-1305
Mailing address
10330 HICKMAN MILLS DR, BLDG 2, KANSAS CITY, MO 64137
(816) 777-1301
(816) 777-1305
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
6497-9809
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
856285408
PROVIDER NUMBER
MO
Enumeration date
04/09/2007
Last updated
06/22/2009
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