Provider Demographics
NPI:1548759590
Name:TEAM COSGROVE, INC
Entity Type:Organization
Organization Name:TEAM COSGROVE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COSGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-529-9621
Mailing Address - Street 1:4761 N 123RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-3802
Mailing Address - Country:US
Mailing Address - Phone:913-529-9621
Mailing Address - Fax:913-225-9848
Practice Address - Street 1:4761 N 123RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-3802
Practice Address - Country:US
Practice Address - Phone:913-529-9621
Practice Address - Fax:913-225-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management