Provider Demographics
NPI:1407151608
Name:TRBHS PHYSICIANS GROUP
Entity Type:Organization
Organization Name:TRBHS PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-382-6313
Mailing Address - Street 1:5121 RAYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-2141
Mailing Address - Country:US
Mailing Address - Phone:816-382-6300
Mailing Address - Fax:816-382-6810
Practice Address - Street 1:5121 RAYTOWN RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-2141
Practice Address - Country:US
Practice Address - Phone:816-382-6300
Practice Address - Fax:816-382-6810
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TWO RIVERS PSYCHIATRIC HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-19
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO349-232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty