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Organization

LIVES WITHOUT LIMITS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS DORIS ANN MARTIN (SECUTARY)
(816) 517-7288
Entity
Organization

Contact information

Practice address
5609 HARDESTY AVE, KANSAS CITY, MO 64130-3229
(816) 517-7288
Mailing address
5609 HARDESTY AVE, KANSAS CITY, MO 64130-3229
(816) 517-7288

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NONE
MO
Enumeration date
10/26/2007
Last updated
10/26/2007
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