Provider Demographics
NPI:1568809556
Name:MISSOURI VALLEY THERAPY COMPANY, LLC
Entity Type:Organization
Organization Name:MISSOURI VALLEY THERAPY COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:MACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:816-547-9248
Mailing Address - Street 1:8575 N GRANBY AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1235
Mailing Address - Country:US
Mailing Address - Phone:816-468-4015
Mailing Address - Fax:816-468-4010
Practice Address - Street 1:8575 N GRANBY AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1235
Practice Address - Country:US
Practice Address - Phone:816-468-4015
Practice Address - Fax:816-468-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI873-27224Z00000X
WI3820-24225100000X
WI1183-19225200000X
WI948-19225200000X
WI654-26225X00000X
WI3041-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty