Provider Demographics
NPI:1689331019
Name:VALIANT THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:VALIANT THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STROTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-991-1976
Mailing Address - Street 1:4444 N BELLEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1507
Mailing Address - Country:US
Mailing Address - Phone:816-569-0557
Mailing Address - Fax:816-379-3784
Practice Address - Street 1:4444 N BELLEVIEW AVE STE 100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1507
Practice Address - Country:US
Practice Address - Phone:816-569-0557
Practice Address - Fax:816-379-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)