Provider Demographics
NPI:1073125589
Name:MELO ENTERPRISES LLC
Entity Type:Organization
Organization Name:MELO ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:OEFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:913-568-5530
Mailing Address - Street 1:15700 KENTUCKY RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-5416
Mailing Address - Country:US
Mailing Address - Phone:913-568-5530
Mailing Address - Fax:
Practice Address - Street 1:119 NE 72ND ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-1826
Practice Address - Country:US
Practice Address - Phone:913-568-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)