Healthcare Provider Details

I. General information

NPI: 1578704268
Provider Name (Legal Business Name): KANSAS CITY AUTISM TRAINING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 BELINDER AVE
PRAIRIE VILLAGE KS
66208-3659
US

IV. Provider business mailing address

5427 JOHNSON DR # 173
MISSION KS
66205-2922
US

V. Phone/Fax

Practice location:
  • Phone: 913-787-3275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: RON LARRY JOHNSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 816-536-9107