MEDICARE: TWO RIVERS PSYCHIATRIC HOSPITAL INC

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	283Q00000X	Psychiatric Hospital	349-19	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548233802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWO RIVERS PSYCHIATRIC HOSPITAL INC

Provider Business Mailing Address
First Line	:	1 DUNWOODY PARK STE 230
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-7404
Country	:	US
Telephone Number	:	678-684-5678
Fax Number	:

Provider Business Practice Location Address
First Line	:	5121 RAYTOWN RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64133-2141
Country	:	US
Telephone Number	:	816-356-5688
Fax Number	:

Authorized Official
Title or Position	:	CFO/SR VP
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	04/11/2019

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