NPI Information

  • NPI: 1255505939
  • Provider Name: DICKERSON ISL
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 9401 E 90TH TER
    KANSAS CITY, MO
    ZIP 64138
  • Phone: (816) 353-8850

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NPI Details

DICKERSON ISL is a community based residential treatment facility, intellectual and/or developmental disabilities in Kansas City, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. DICKERSON ISL NPI is 1255505939. The provider is registered as an organization entity type.

The provider's business location address is:

9401 E 90TH TER
KANSAS CITY, MO
ZIP 64138-770
Phone: (816) 353-8850

The provider's authorized official is Charles Ray Dickerson .
The authorized official title is Provider and has the following contact phone number (816) 353-8850.

The enumeration date for this NPI number is 4/14/2008 and was last updated on 4/14/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities9227MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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