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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LUECREASEA RENEE HORNE (DIRECTOR)
(816) 326-7843
Entity
Organization

Contact information

Practice address
8308 E 93RD ST, KANSAS CITY, MO 64138-4609
(816) 326-7843
Mailing address
8308 E 93RD ST, KANSAS CITY, MO 64138-4609
(816) 326-7843

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320700000X
Physical Disabilities Residential Treatment Facility
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
09/23/2009
Last updated
09/23/2009
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