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General NPI Number Information
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NPI Number | 1881342921
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Entity Type | Organization
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Legal Business Name | HARAMBEE CIRCLE
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 2701 E 31ST ST
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City | KANSAS CITY
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State | MO
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Zip | 64128-1516
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Country | US
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Telephone | 816-365-0077
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 140312
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City | KANSAS CITY
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State | MO
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Zip | 64114-0312
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Country | US
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Telephone | 816-365-0077
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRYAN DIAL
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Credential |
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Telephone | 816-365-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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