Provider Demographics
NPI:1427584887
Name:THE TRINITY GROUP OF KANSAS CITY, LLC
Entity Type:Organization
Organization Name:THE TRINITY GROUP OF KANSAS CITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY PRINCIPAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-215-4822
Mailing Address - Street 1:8826 SANTA FE DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-3655
Mailing Address - Country:US
Mailing Address - Phone:816-945-6612
Mailing Address - Fax:866-264-4946
Practice Address - Street 1:8826 SANTA FE DR
Practice Address - Street 2:SUITE 219
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3655
Practice Address - Country:US
Practice Address - Phone:816-945-6612
Practice Address - Fax:866-264-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160275201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO002571300OtherCHILDRENS DIVISION