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General NPI Number Information
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NPI Number | 1043382740
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Entity Type | Organization
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Legal Business Name | INTERFAITH COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 5400 KING HILL AVE
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City | SAINT JOSEPH
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State | MO
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Zip | 64504-1503
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Country | US
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Telephone | 816-238-4511
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Fax | 816-232-7029
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Provider Business Mailing Address
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Address Line | 5400 KING HILL AVE
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City | SAINT JOSEPH
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State | MO
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Zip | 64504-1503
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Country | US
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Telephone | 816-238-4511
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Fax | 816-232-7029
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRIDGET SUPPLE
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Credential |
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Telephone | 816-238-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | MO
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