Healthcare Provider Details

I. General information

NPI: 1508552340
Provider Name (Legal Business Name): TURNER HOUSE CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 N 12TH ST STE 300
KANSAS CITY KS
66102-5105
US

IV. Provider business mailing address

21 N 12TH ST STE 300
KANSAS CITY KS
66102-5105
US

V. Phone/Fax

Practice location:
  • Phone: 913-391-4292
  • Fax:
Mailing address:
  • Phone: 913-391-4292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JEREMY M GREENE
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 913-342-2552