Organization
NOVA CENTER
Active
Other names
madison
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARY WILLIAMS (CEO)
(816) 761-8614
Entity
Organization
Contact information
Practice address
8401 HICKMAN MILLS DR, KANSAS CITY, MO 64132-2513
(816) 761-8614
(816) 765-0622
Mailing address
8401 HICKMAN MILLS DR, KANSAS CITY, MO 64132-2513
(816) 761-8614
(816) 765-0622
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856135405
—
MO
Enumeration date
04/26/2007
Last updated
05/14/2014
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