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General NPI Number Information
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NPI Number | 1033653928
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Entity Type | Organization
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Legal Business Name | REFLECTION OF REALITY
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 1734 E 63RD ST SUITE # 312
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City | KANSAS CITY
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State | MO
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Zip | 64110-3543
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Country | US
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Telephone | 816-255-5583
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Fax |
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Provider Business Mailing Address
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Address Line | 1734 E 63RD SUITE # 312
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City | KANSAS CITY
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State | MO
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Zip | 64110
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Country | US
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Telephone | 816-255-5583
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. TAMIRRIA SMITH
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Credential |
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Telephone | 816-255-5583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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