Healthcare Provider Details

I. General information

NPI: 1639559685
Provider Name (Legal Business Name): COMMUNITY TREATMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 12/24/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 E CEDAR ST STE 102
OLATHE KS
66062-1886
US

IV. Provider business mailing address

1308 S. ALLENDALE RD
GREENWOOD MO
64034
US

V. Phone/Fax

Practice location:
  • Phone: 816-977-3178
  • Fax: 816-572-6838
Mailing address:
  • Phone: 816-977-3178
  • Fax: 816-572-6838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3935
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STACEY ELAINE TADOKORO
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 816-977-3178