MEDICARE: SARITA'LYNNE MINISTRIES

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1447388210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARITA'LYNNE MINISTRIES

Provider Business Mailing Address
First Line	:	207 W LINWOOD BLVD # 23
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-1327
Country	:	US
Telephone Number	:	816-561-0035
Fax Number	:	816-531-0583

Provider Business Practice Location Address
First Line	:	207 W LINWOOD BLVD # 23
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-1327
Country	:	US
Telephone Number	:	816-561-0035
Fax Number	:	816-531-0583

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. SARITA LYNN GRAHAM
Credential	:
Telephone Number	:	816-561-0035

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	08/22/2020

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Directions to “SARITA'LYNNE MINISTRIES ” Practice Location

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