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General NPI Number Information
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NPI Number | 1306387063
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Entity Type | Organization
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Legal Business Name | HOUSE OF PARADISE LLC
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 1201 NW BRIARCLIFF PKWY 2ND FLOOR
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City | KANSAS CITY
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State | MO
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Zip | 64116-1878
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Country | US
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Telephone | 913-244-4583
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Fax | 888-854-8514
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Provider Business Mailing Address
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Address Line | 1201 NW BRIARCLIFF PKWY 2ND FLOOR
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City | KANSAS CITY
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State | MO
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Zip | 64116-1878
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Country | US
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Telephone | 913-244-4583
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Fax | 888-854-8514
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL BROOKS
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Credential |
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Telephone | 913-244-4583
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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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