Organization
C AND M SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTIAN ROYAL CROCKETT (OWNER/DIRECTOR)
(816) 977-1284
Entity
Organization
Contact information
Practice address
6220 JACKSON AVE, KANSAS CITY, MO 64130-4407
(816) 977-1284
(816) 361-6167
Mailing address
6220 JACKSON AVE, KANSAS CITY, MO 64130-4407
(816) 977-1284
(816) 361-6167
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
MO
Other
Enumeration date
08/08/2007
Last updated
07/21/2022
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