Provider Demographics
NPI:1578614509
Name:HARRY S. TRUMAN CHILDRENS NEUROLOGICAL CTR
Entity Type:Organization
Organization Name:HARRY S. TRUMAN CHILDRENS NEUROLOGICAL CTR
Other - Org Name:TNC COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HURBBER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-373-5060
Mailing Address - Street 1:15600 WOODS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64139-1354
Mailing Address - Country:US
Mailing Address - Phone:816-373-5060
Mailing Address - Fax:816-373-5060
Practice Address - Street 1:519 NW 43RD TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1603
Practice Address - Country:US
Practice Address - Phone:816-455-5265
Practice Address - Fax:815-455-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO8000925Medicaid
MO=========02OtherSAM II VENDOR CODE