Healthcare Provider Details

I. General information

NPI: 1417096330
Provider Name (Legal Business Name): REDISCOVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 NE COLUMBUS ST
LEES SUMMIT MO
64064
US

IV. Provider business mailing address

1555 NE RICE RD
LEES SUMMIT MO
64086-5849
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-8000
  • Fax: 816-524-2235
Mailing address:
  • Phone: 816-966-0900
  • Fax: 816-347-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number12947661
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number12947661
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number2229895
License Number StateMO

VIII. Authorized Official

Name: MR. STEWART ALAN CHASE
Title or Position: SENIOR VICE PRESIDENT
Credential: MA
Phone: 816-347-3243