Provider Demographics
NPI:1821271958
Name:T C J ENTERPRISE
Entity Type:Organization
Organization Name:T C J ENTERPRISE
Other - Org Name:PEACE DAY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF RESIDENTIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JOE
Authorized Official - Middle Name:ELLA
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-838-4095
Mailing Address - Street 1:10540 MARTY
Mailing Address - Street 2:200-C
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:816-942-3909
Practice Address - Street 1:10540 MARTY
Practice Address - Street 2:200-C
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212
Practice Address - Country:US
Practice Address - Phone:816-838-4095
Practice Address - Fax:816-942-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251B00000X, 251C00000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services