Organization
BETTY LOU WALLACE RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEFFEN LIBERMAN (EXECUTIVE DIRECTOR)
(480) 388-1495
Entity
Organization
Contact information
Practice address
13643 HOLMES RD, KANSAS CITY, MO 64145-1482
(480) 388-1495
Mailing address
13340 HOLMES RD, KANSAS CITY, MO 64145-1437
(816) 786-7074
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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