DICKERSON ISL NPI 1255505939

NPI Information

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:

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