Provider Demographics
NPI:1558970087
Name:MBS ENVISION LLC
Entity Type:Organization
Organization Name:MBS ENVISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CORREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-233-6307
Mailing Address - Street 1:11350 TOMAHAWK CREEK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-2617
Mailing Address - Country:US
Mailing Address - Phone:913-359-6021
Mailing Address - Fax:
Practice Address - Street 1:601 E MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-7460
Practice Address - Country:US
Practice Address - Phone:913-359-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty