Organization Name: | COMMUNITY ACCESS |
NPI Number: | 1033383641 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLY LYNNE TAULA (OFFICE MANAGER) |
Mailing Address: | 1402 S Lees Summit Rd Independence |
State: | MO US |
Postal Code: | 640504117 |
Phone Number: | 8162577222 |
Fax Number: | 8162577188 |
NPI Enumeration Date: | 04/15/2008 |
NPI Last Update Date: | 04/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 8000787 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |