Healthcare Provider Details

I. General information

NPI: 1235279779
Provider Name (Legal Business Name): REDISCOVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NE INDEPENDENCE AVE
LEES SUMMIT MO
64086-5544
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: 816-246-8207
Mailing address:
  • Phone: 816-246-8000
  • Fax: 816-347-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

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