Individual
CHARLES MUTUMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9807 WORNALL RD, #D, KANSAS CITY, MO 64114-3986
(816) 589-7475
Mailing address
9807 WORNALL RD, #D, KANSAS CITY, MO 64114-3986
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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