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Organization

COMMUNITY HOUSE OF WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARVIN MCINTOSH MEDICAL DOCTOR (MEDICAL DIRECTOR)
(913) 233-1733
Entity
Organization

Contact information

Practice address
1121 QUINDARO BLVD, KANSAS CITY, KS 66104-5331
(913) 233-1733
(913) 233-0055
Mailing address
1121 QUINDARO BLVD, KANSAS CITY, KS 66104-5331
(913) 233-1733
(913) 233-0055

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0428352
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200006440A
KS
05
200006440D
KS
01
464791
CHILDREN'S MERCY HEALTH P
KS
Enumeration date
05/15/2007
Last updated
09/29/2010
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