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General NPI Number Information
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NPI Number | 1356533194
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Entity Type | Organization
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Legal Business Name | LEVELUP KIDS, INC.
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 5416 NE ANTIOCH ROAD
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City | KANSAS CITY
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State | MO
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Zip | 64119
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Country | US
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Telephone | 816-413-9009
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Fax | 816-413-9009
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Provider Business Mailing Address
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Address Line | 5416 NE ANTIOCH RD
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City | KANSAS CITY
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State | MO
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Zip | 64119-2507
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Country | US
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Telephone | 816-413-9009
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Fax | 816-413-9009
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CHRISTY K MAY
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Credential | M.P.A.
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Telephone | 816-413-9009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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