Organization
KIDZ CONNECTION GROUP HOME
Active
Other names
Jackson Style Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEOTHA JACKSON (ASST. ADMINISTRATOR)
(816) 765-9990
Entity
Organization
Contact information
Practice address
11815 BEACON AVE, KANSAS CITY, MO 64134-3708
(816) 763-8335
(816) 765-9987
Mailing address
213 BLUE RIDGE EXT, GRANDVIEW, MO 64030-1604
(816) 765-9990
(816) 765-9987
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/12/2007
Last updated
07/12/2007
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