Healthcare Provider Details

I. General information

NPI: 1710015375
Provider Name (Legal Business Name): THE COMMUNITY OF THE GOOD SHEPHERD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 JAMES A REED RD
KANSAS CITY MO
64134-2185
US

IV. Provider business mailing address

10101 JAMES A REED RD
KANSAS CITY MO
64134-2183
US

V. Phone/Fax

Practice location:
  • Phone: 816-767-0292
  • Fax:
Mailing address:
  • Phone: 816-767-8090
  • Fax: 816-767-8091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberMW014114
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberMW014114
License Number StateMO

VIII. Authorized Official

Name: MRS. KRISTA RENEE' BAUMGARDNER
Title or Position: ACCOUNTING CLERK
Credential:
Phone: 816-767-8090