Provider Demographics
NPI:1598810582
Name:KVC BEHAVIORAL HEALTHCARE MISSOURI INC
Entity Type:Organization
Organization Name:KVC BEHAVIORAL HEALTHCARE MISSOURI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-241-3448
Mailing Address - Street 1:1911 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64127-3701
Mailing Address - Country:US
Mailing Address - Phone:816-241-3448
Mailing Address - Fax:816-231-9368
Practice Address - Street 1:1911 E 23RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127-3701
Practice Address - Country:US
Practice Address - Phone:816-241-3448
Practice Address - Fax:816-231-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 3245S0500X
MO00042591322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO507586907Medicaid
KS100007450AMedicaid
MO1255655619OtherDARK, STEPHANIE
KS100007450AMedicaid
MO1275835159OtherCARSON, YOLONDA