MEDICARE: THE BLUE DOOR PROJECT, 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	320800000X	Mental Illness Community Based Residential Treatment Facility		KS

General Provider Information

NPI Number	:	1629507306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BLUE DOOR PROJECT, INC.

Provider Business Mailing Address
First Line	:	3535 WOOD AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-2141
Country	:	US
Telephone Number	:	913-730-5120
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 WOOD AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-2141
Country	:	US
Telephone Number	:	913-730-5120
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. CARLA ANN DRESCHER
Credential	:	LMSW
Telephone Number	:	913-961-0866

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	07/21/2022

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