Provider Demographics
NPI:1003970567
Name:UNITED CEREBRAL PALSY OF NORTHWEST MISSOURI
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF NORTHWEST MISSOURI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-364-3836
Mailing Address - Street 1:3303 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2985
Mailing Address - Country:US
Mailing Address - Phone:816-364-3836
Mailing Address - Fax:816-390-8546
Practice Address - Street 1:3303 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2985
Practice Address - Country:US
Practice Address - Phone:816-364-3836
Practice Address - Fax:816-390-8546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable