Organization
EATING DISORDERS PROGRAM OF KANSAS CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIMI ZIMMERMAN LCSW (CO-OWNER)
(816) 942-1811
Entity
Organization
Contact information
Practice address
400 E RED BRIDGE RD, SUITE 304, KANSAS CITY, MO 64131-4035
(816) 942-1811
(816) 942-0419
Mailing address
400 E RED BRIDGE RD, SUITE 304, KANSAS CITY, MO 64131-4035
(816) 942-1811
(816) 942-0419
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13005012
BCBSKC
MO
Enumeration date
06/11/2006
Last updated
02/26/2010
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