Healthcare Provider Details

I. General information

NPI: 1578488078
Provider Name (Legal Business Name): CROOKED RIVER ENDEAVORS ELM STREET APARTMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NE 1ST ST
HARDIN MO
64035-7135
US

IV. Provider business mailing address

507 SOUTHVIEW DR
RICHMOND MO
64085-2317
US

V. Phone/Fax

Practice location:
  • Phone: 816-694-8911
  • Fax:
Mailing address:
  • Phone: 816-694-8911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON ROBERT RAASCH
Title or Position: DIRECTOR
Credential:
Phone: 816-694-8911