Provider Demographics
NPI:1609376193
Name:PIZZAZZ PERSONAL GROWTH, INCORPORATED
Entity Type:Organization
Organization Name:PIZZAZZ PERSONAL GROWTH, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:816-305-0839
Mailing Address - Street 1:908 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1013
Mailing Address - Country:US
Mailing Address - Phone:816-305-0839
Mailing Address - Fax:816-942-6410
Practice Address - Street 1:5801 W 115TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1800
Practice Address - Country:US
Practice Address - Phone:816-305-0839
Practice Address - Fax:816-942-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00845479251S00000X
MO00845479251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health