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General NPI Number Information
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NPI Number | 1821263211
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Entity Type | Organization
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Legal Business Name | MIDWEST ADP INC
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 3923 S LYNN CT
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City | INDEPENDENCE
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State | MO
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Zip | 64055-3337
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Country | US
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Telephone | 816-836-2220
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Fax | 816-836-3567
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Provider Business Mailing Address
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Address Line | 3923 S LYNN CT
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City | INDEPENDENCE
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State | MO
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Zip | 64055-3337
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Country | US
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Telephone | 816-836-2220
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Fax | 816-836-3567
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BRAD M RENTFROW
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Credential |
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Telephone | 816-836-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 110
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License Number State | MO
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