Organization
COLA'S PLACE
Active
Other names
Cola's Place North
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMATHA MONICA ELLIOTT-GRAY (OWNER/ADMINISTRATOR)
(816) 920-6084
Entity
Organization
Contact information
Practice address
6507 NW HILLDALE DR, KANSAS CITY, MO 64151-2328
(816) 587-8317
Mailing address
420 CYPRESS AVE, KANSAS CITY, MO 64124-2145
(816) 920-6084
(816) 920-6084
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
855991907
—
MO
Enumeration date
08/04/2008
Last updated
08/04/2008
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