Organization
LIFE LONG LEARNING CENTER INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ADA L SILVY ACSW, LCSW, MSW (PRESIDENT,OWNER)
(816) 232-2514
Entity
Organization
Contact information
Practice address
2400 FREDERICK AVE, SUITE 108, SAINT JOSEPH, MO 64506-2758
(816) 232-2514
(816) 232-5354
Mailing address
2400 FREDERICK AVE, SUITE 108, SAINT JOSEPH, MO 64506-2758
(816) 232-2514
(816) 232-5354
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003482
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001243000
COMMUNITY HEALTH PLAN
MO
01
—
27016014
BLUE CROSS BLUE SHIELD
MO
05
—
493600902
—
MO
Enumeration date
01/04/2007
Last updated
05/17/2010
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