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General NPI Number Information
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NPI Number | 1053584268
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Entity Type | Organization
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Legal Business Name | SUPPORTING HEARTS
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 7344 INDIANA AVE
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City | KANSAS CITY
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State | MO
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Zip | 64132-1912
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Country | US
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Telephone | 816-241-0465
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 ROBERTS ST
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City | KANSAS CITY
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State | MO
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Zip | 64124-1927
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Country | US
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Telephone | 816-241-0465
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Fax | 816-241-0465
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | MARSCHELLE TRE'NICCE HORTON
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Credential |
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Telephone | 816-359-9202
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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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