Individual
WADE MCCUMBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11816 N CHARLOTTE ST, KANSAS CITY, MO 64155-1094
(816) 824-6634
Mailing address
11816 N CHARLOTTE ST, KANSAS CITY, MO 64155-1094
(816) 824-6634
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
LC1390708
MO
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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