Organization
GARDEN OF SUCCESS DBA: SUPPORT PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PATRICE WANETTA DUMAS (ADMINISTRATOR)
(816) 217-1791
Entity
Organization
Contact information
Practice address
18813 E 25TH ST S, INDEPENDENCE, MO 64057-2467
(816) 217-1791
(816) 817-0087
Mailing address
18813 E 25TH ST S, INDEPENDENCE, MO 64057-2467
(816) 217-1791
(816) 817-0087
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740486430
—
MO
Enumeration date
04/18/2008
Last updated
04/18/2008
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