Healthcare Provider Details

I. General information

NPI: 1912989351
Provider Name (Legal Business Name): CASS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E MECHANIC ST
HARRISONVILLE MO
64701-2017
US

IV. Provider business mailing address

1800 E MECHANIC ST
HARRISONVILLE MO
64701-2017
US

V. Phone/Fax

Practice location:
  • Phone: 816-380-3474
  • Fax: 816-380-4639
Mailing address:
  • Phone: 816-380-3474
  • Fax: 816-380-4639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number219-42
License Number StateMO

VIII. Authorized Official

Name: MR. J CHRISTOPHER LANG
Title or Position: CEO
Credential:
Phone: 816-380-5888