Organization
ROSWELL ADDICTION TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES O. MAXWELL D.MIN (EXECUTIVE DIRECTOR)
(913) 957-3596
Entity
Organization
Contact information
Practice address
1401 N 18TH ST, KANSAS CITY, KS 66102-2845
(913) 387-4773
(913) 621-2297
Mailing address
1401 N 18TH ST, KANSAS CITY, KS 66102-2845
(913) 387-4773
(913) 621-2297
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
07070894
KS
Other
Enumeration date
01/09/2010
Last updated
01/09/2010
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