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General NPI Number Information
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NPI Number | 1699899328
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Entity Type | Organization
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Legal Business Name | DEVELOPING POTENTIAL, INC.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 1608A PROSPECT AVE.
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City | KANSAS CITY
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State | MO
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Zip | 64127-2542
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Country | US
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Telephone | 816-252-0086
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Fax | 816-525-6003
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Provider Business Mailing Address
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Address Line | 120 W WALNUT ST
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City | INDEPENDENCE
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State | MO
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Zip | 64050-3846
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Country | US
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Telephone | 816-252-0086
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Fax | 816-525-6003
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. REBECCA ANN CASE
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Credential |
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Telephone | 816-252-0086
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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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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 15312631
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License Number State | MO
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