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General NPI Number Information
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NPI Number | 1588328579
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Entity Type | Organization
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Legal Business Name | ACADEMY OF ADDICTION SERVICES
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 1734 E 63RD ST STE 4
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City | KANSAS CITY
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State | MO
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Zip | 64110-3543
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Country | US
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Telephone | 816-820-7739
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Fax |
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Provider Business Mailing Address
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Address Line | 1734 E 63RD ST STE 4
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City | KANSAS CITY
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State | MO
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Zip | 64110-3543
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Country | US
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Telephone | 816-820-7739
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOANN STOVALL
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Credential | LMSW, CRAADC, LCAC
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Telephone | 816-820-7739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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