Organization
HARRY S TRUMAN CHILDRENS NEUROLOGICAL CENTER
Active
Other names
TNC COmmunity
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DEXTER LANDRUM MSW (EXECUTIVE DIRECTOR)
(816) 373-5060
Entity
Organization
Contact information
Practice address
12404 E US HIGHWAY 40, INDEPENDENCE, MO 64055-5954
(816) 373-5060
(816) 373-5797
Mailing address
12404 E US HIGHWAY 40, INDEPENDENCE, MO 64055-5954
(816) 373-5060
(816) 373-5797
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
12606545
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4406082902
MISSOURI STATE VENDOR NUMBER
MO
05
—
852522804
—
MO
05
—
852522838
—
MO
05
—
852522846
—
MO
05
—
852522853
—
MO
05
—
852522861
—
MO
05
—
856388004
—
MO
Enumeration date
07/21/2011
Last updated
07/21/2011
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