Provider Demographics
NPI:1861662827
Name:DEVELOPMENTAL DISABILITY SERVICES OF JACKSON COUNTY - EITAS
Entity Type:Organization
Organization Name:DEVELOPMENTAL DISABILITY SERVICES OF JACKSON COUNTY - EITAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EVERETT
Authorized Official - Middle Name:'JAKE'
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:816-363-2000
Mailing Address - Street 1:8508 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-2762
Mailing Address - Country:US
Mailing Address - Phone:816-363-2000
Mailing Address - Fax:816-363-1755
Practice Address - Street 1:8508 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-2762
Practice Address - Country:US
Practice Address - Phone:816-363-2000
Practice Address - Fax:816-363-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management