Provider Demographics
NPI:1588795900
Name:SPECIALIZED SUPPORT SERVICES, INC
Entity Type:Organization
Organization Name:SPECIALIZED SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAHOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-279-9090
Mailing Address - Street 1:1353 BUCHANAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-2003
Mailing Address - Country:US
Mailing Address - Phone:816-279-9090
Mailing Address - Fax:816-279-9019
Practice Address - Street 1:1353 BUCHANAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-2003
Practice Address - Country:US
Practice Address - Phone:816-279-9090
Practice Address - Fax:816-279-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services