Healthcare Provider Details

I. General information

NPI: 1548233802
Provider Name (Legal Business Name): TWO RIVERS PSYCHIATRIC HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 RAYTOWN RD
KANSAS CITY MO
64133-2141
US

IV. Provider business mailing address

1 DUNWOODY PARK STE 230
DUNWOODY GA
30338-7404
US

V. Phone/Fax

Practice location:
  • Phone: 816-356-5688
  • Fax:
Mailing address:
  • Phone: 678-684-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number349-19
License Number StateMO

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: CFO/SR VP
Credential:
Phone: 610-768-3300