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General NPI Number Information
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NPI Number | 1689331019
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Entity Type | Organization
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Legal Business Name | VALIANT THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 11/19/2021
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 4444 N BELLEVIEW AVE STE 100
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City | KANSAS CITY
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State | MO
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Zip | 64116-1507
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Country | US
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Telephone | 816-569-0557
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Fax | 816-379-3784
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Provider Business Mailing Address
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Address Line | 4444 N BELLEVIEW AVE
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City | KANSAS CITY
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State | MO
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Zip | 64116-1507
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Country | US
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Telephone | 816-569-0557
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Fax | 816-379-3784
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Authorized Official
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Title or Position | OWNER
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Name | DAVID STROTHER
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Credential |
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Telephone | 913-991-1976
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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