Organization
OZANAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DALE WHITTEN II MS, NCC, LPC (VICE PRESIDENT)
(816) 508-3600
Entity
Organization
Contact information
Practice address
421 E 137TH ST, KANSAS CITY, MO 64145-1455
(816) 508-3600
(816) 508-3797
Mailing address
421 E 137TH ST, KANSAS CITY, MO 64145-1455
(816) 508-3600
(816) 508-3797
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
000042582
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500100300
—
MO
Enumeration date
01/10/2007
Last updated
07/30/2015
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