Healthcare Provider Details

I. General information

NPI: 1497795892
Provider Name (Legal Business Name): MIDWEST DIVISION - RPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 E 63RD ST
KANSAS CITY MO
64130-3462
US

IV. Provider business mailing address

2323 E 63RD ST
KANSAS CITY MO
64130-3462
US

V. Phone/Fax

Practice location:
  • Phone: 816-444-8161
  • Fax: 816-333-4495
Mailing address:
  • Phone: 816-444-8161
  • Fax: 816-333-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: DANIEL FEHR
Title or Position: CONTROLLER
Credential:
Phone: 816-235-8108