Provider Demographics
NPI:1720438302
Name:TRUMAN MEDICAL CENTER, INCORPORATED
Entity Type:Organization
Organization Name:TRUMAN MEDICAL CENTER, INCORPORATED
Other - Org Name:MENTAL HEALTH CRISIS PREVENTION PROJECT
Other - Org Type:Other Name
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-404-3485
Mailing Address - Street 1:300 W 19TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2026
Mailing Address - Country:US
Mailing Address - Phone:816-404-5700
Mailing Address - Fax:
Practice Address - Street 1:300 W 19TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2026
Practice Address - Country:US
Practice Address - Phone:816-404-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUMAN MEDICAL CENTER, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QM0850X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO156772907Medicaid