Provider Demographics
NPI:1447569991
Name:MATTIE RHODES MEMORIAL SOCIETY
Entity Type:Organization
Organization Name:MATTIE RHODES MEMORIAL SOCIETY
Other - Org Name:MATTIE RHODES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-581-5606
Mailing Address - Street 1:1740 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-1104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1740 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1104
Practice Address - Country:US
Practice Address - Phone:816-471-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health