Provider Demographics
NPI:1376868059
Name:PLAZA ACADEMY
Entity Type:Organization
Organization Name:PLAZA ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:OGLE
Authorized Official - Last Name:SEABAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:816-561-0770
Mailing Address - Street 1:601 WESTPORT RD
Mailing Address - Street 2:P.O. BOX 10361
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3127
Mailing Address - Country:US
Mailing Address - Phone:816-561-0770
Mailing Address - Fax:816-561-2530
Practice Address - Street 1:601 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3127
Practice Address - Country:US
Practice Address - Phone:816-561-0770
Practice Address - Fax:816-561-2530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health