Organization
REACHING OUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK LAMONT SPRUILL SR. (DIRECTOR)
(816) 678-3522
Entity
Organization
Contact information
Practice address
8300 BOOTH AVE, RAYTOWN, MO 64138-3045
(816) 313-6996
Mailing address
8716 LONGVIEW CT, KANSAS CITY, MO 64134-3674
(816) 765-0680
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/19/2008
Last updated
02/19/2008
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