MEDICARE: STONE AND BUSH HOMES,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	004988	MO

General Provider Information

NPI Number	:	1184141202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE AND BUSH HOMES,LLC

Provider Business Mailing Address
First Line	:	PO BOX 3443
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66063-3443
Country	:	US
Telephone Number	:	913-707-3240
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 E 63RD ST STE 212
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64110-3372
Country	:	US
Telephone Number	:	913-707-3240
Fax Number	:	816-281-9622

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	TINA B STONE
Credential	:	LCSW,LSCSW
Telephone Number	:	913-707-3240

Provider Enumeration Date	:	08/29/2017
Last Update Date	:	01/10/2022

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