Organization
CENTER FOR DEVELOPMENTALLY DISABLED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM J JOHNSON (EXECUTIVE DIRECTOR)
(816) 531-0045
Entity
Organization
Contact information
Practice address
1010 W 39TH ST, KANSAS CITY, MO 64111-3880
(816) 531-0045
(816) 756-5612
Mailing address
1010 W 39TH ST, KANSAS CITY, MO 64111-3880
(816) 531-0045
(816) 756-5612
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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