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
8600 E 74TH ST, KANSAS CITY, MO 64133-6318
(816) 777-1301
(816) 777-1305
Mailing address
10330 HICKMAN MILLS DR, BLDG 2, KANSAS CITY, MO 64137-1618
(816) 777-1301
(816) 777-1305
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
6368-9311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
856252903
PROVIDER NUMBER
MO
Enumeration date
02/01/2007
Last updated
06/09/2009
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