Healthcare Provider Details

I. General information

NPI: 1104750017
Provider Name (Legal Business Name): IDEAL INDUSTRIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N THORNTON ST
RICHMOND MO
64085-1459
US

IV. Provider business mailing address

601 N THORNTON ST
RICHMOND MO
64085-1459
US

V. Phone/Fax

Practice location:
  • Phone: 816-470-7137
  • Fax: 816-470-7137
Mailing address:
  • Phone: 816-470-7137
  • Fax: 816-470-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NATALIE FIELDS
Title or Position: DIRECTOR
Credential: MS, ED
Phone: 816-470-7137