Organization
SIDE BY SIDE II, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEE WEISENBORN (C.E.O.)
(816) 729-7389
Entity
Organization
Contact information
Practice address
6612 BLUE RIDGE BLVD, RAYTOWN, MO 64133-4847
(816) 356-0923
Mailing address
6612 BLUE RIDGE BLVD, RAYTOWN, MO 64133-4847
(816) 356-0923
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8001199
—
MO
05
—
8001793
—
MO
05
—
8002062
—
MO
Enumeration date
03/21/2007
Last updated
08/22/2020
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