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Active
Organization subpart
No

Provider details

NPI number
Authorized official
CLEMEITA BACHUS (CEO/OWNER)
(816) 876-1542
Entity
Organization

Contact information

Practice address
1404 N 77TH ST, KANSAS CITY, KS 66112-2434
(816) 876-1542
Mailing address
1404 N 77TH ST, KANSAS CITY, KS 66112-2434
(816) 876-1542

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
251J00000X
Nursing Care Agency
Primary

Other

Enumeration date
08/28/2019
Last updated
08/28/2019
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