=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104750017
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IDEAL INDUSTRIES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2026
-----------------------------------------------------
Last Update Date | 06/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 N THORNTON ST
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64085-1459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-470-7137
-----------------------------------------------------
Fax | 816-470-7137
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 N THORNTON ST
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64085-1459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-470-7137
-----------------------------------------------------
Fax | 816-470-7137
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | NATALIE FIELDS
-----------------------------------------------------
Credential | MS, ED
-----------------------------------------------------
Telephone | 816-470-7137
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------