Healthcare Provider Details

I. General information

NPI: 1982989133
Provider Name (Legal Business Name): TRI-COUNTY MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 12/18/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NE 83RD ST SUITE 1001
KANSAS CITY MO
64119-4400
US

IV. Provider business mailing address

3100 NE 83RD ST SUITE 1001
KANSAS CITY MO
64119-4400
US

V. Phone/Fax

Practice location:
  • Phone: 816-468-0400
  • Fax:
Mailing address:
  • Phone: 816-468-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number2011029969
License Number StateMO

VIII. Authorized Official

Name: CHRISTINA MARIE HOLM
Title or Position: CHIEF QUALITY & COMPLIANCE OFFICER
Credential:
Phone: 816-468-0400