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General NPI Number Information
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NPI Number | 1639559685
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Entity Type | Organization
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Legal Business Name | COMMUNITY TREATMENT SERVICES, LLC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 1707 E CEDAR ST STE 102
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City | OLATHE
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State | KS
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Zip | 66062-1886
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Country | US
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Telephone | 816-977-3178
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Fax | 816-572-6838
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Provider Business Mailing Address
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Address Line | 1308 S. ALLENDALE RD
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City | GREENWOOD
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State | MO
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Zip | 64034
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Country | US
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Telephone | 816-977-3178
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Fax | 816-572-6838
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | STACEY ELAINE TADOKORO
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Credential |
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Telephone | 816-977-3178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3935
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License Number State | KS
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