Healthcare Provider Details

I. General information

NPI: 1871953828
Provider Name (Legal Business Name): EPISCOPAL COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E 40TH ST
KANSAS CITY MO
64111-4909
US

IV. Provider business mailing address

11 E 40TH ST
KANSAS CITY MO
64111-4909
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-8920
  • Fax:
Mailing address:
  • Phone: 816-561-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BEAU HEYEN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 816-561-8920