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MULBERRY STREET LLC NPI 1902099013


NPI Information

NPI: 1902099013
Provider Name: MULBERRY STREET LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
1519 SW STATE ROUTE 7
BLUE SPRINGS, MO
ZIP 64014
Phone: (816) 224-2000
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MULBERRY STREET LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Blue Springs, 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. MULBERRY STREET LLC NPI is 1902099013. The provider is registered as an organization entity type.

The provider's business location address is:

1519 SW STATE ROUTE 7
BLUE SPRINGS, MO
ZIP 64014-944
Phone: (816) 224-2000

The provider's authorized official is Diane Marie Mack .
The authorized official title is President and has the following contact phone number (816) 224-2000.

The enumeration date for this NPI number is 8/22/2007 and was last updated on 1/7/2013.


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 DisabilitiesYes

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: 5/5/2024

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