MEDICARE: INSIGHT INDUSTRY 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1689206211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT INDUSTRY LLC

Provider Business Mailing Address
First Line	:	2501 NE PRAIRIE FALCON DR
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-1958
Country	:	US
Telephone Number	:	816-423-1620
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 NE PRAIRIE FALCON DR
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-1958
Country	:	US
Telephone Number	:	816-423-1620
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ALAN WARE
Credential	:
Telephone Number	:	816-412-0853

Provider Enumeration Date	:	02/11/2020
Last Update Date	:	02/11/2020

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