institution
Alyce D. Clark
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kansas City, Missouri
NPI 1649398769

Alyce D. Clark is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Kansas City, MO. Alyce D. Clark practices in Kansas City, MO. The NPI Number for Alyce D. Clark is 1649398769 and holds a License No. 856274402 (Missouri).

The current practice location address for Alyce D. Clark is 10640 Holmes Road, Kansas City, MO and can be reached out via phone at 816-943-1300 and via fax at 816-942-7443. You can also correspond with Alyce D. Clark through the mailing address at 10640 HOLMES RD, KANSAS CITY, MO - 64131-3404 (mailing address contact number: 816-943-1300).

Location: 10640 Holmes Road, Kansas City, MO, 64131-3404
institution
Provider Profile Details
NPI Number
1649398769
Provider Name
Alyce D. Clark
Credential
Provider Entity Type
Organization
Address
10640 Holmes Road, Kansas City, MO, 64131-3404
Phone Number
816-943-1300
Fax Number
816-942-7443
Provider Enumeration Date
03/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8002103 01 MO DMH VENDOR NUMBER
856274402 05 MO
institution
Provider Business Practice Location Address Details
Address
10640 Holmes Road
City
State
Zip
64131-3404
Phone Number
816-943-1300
Fax Number
816-942-7443
person
Provider Business Mailing Address Details
Address
10640 Holmes Road
City
State
Zip
64131-3404
Phone Number
816-943-1300
Fax Number
816-942-7443
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
856274402 (Missouri)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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