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Organization

PEP PHYSICAL & EMOTIONAL POWER FOR LIFE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACQUELINE KEITEL LSCSW, LCSW (OWNER)
(816) 872-2463
Entity
Organization

Contact information

Practice address
7280 NW 87TH TER, #210, KANSAS CITY, MO 64153-3720
(816) 872-2463
(816) 533-7220
Mailing address
7280 NW 87TH TER, #210, KANSAS CITY, MO 64153-3720
(816) 872-2463
(816) 533-7220

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2003022197
MO
251S00000X
Community/Behavioral Health Agency
2387
KS

Other

Enumeration date
09/16/2010
Last updated
10/05/2010
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