Healthcare Provider Details

I. General information

NPI: 1851536858
Provider Name (Legal Business Name): WESTERN MISSOURI MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E 24TH ST
KANSAS CITY MO
64108-2776
US

IV. Provider business mailing address

1000 E 24TH ST
KANSAS CITY MO
64108-2776
US

V. Phone/Fax

Practice location:
  • Phone: 816-512-7299
  • Fax: 816-512-7216
Mailing address:
  • Phone: 816-512-7299
  • Fax: 816-512-7216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARA CLARK
Title or Position: CLINICAL CASEWORK PRACTITIONER II
Credential: MSW
Phone: 816-512-7299