Individual Expressions, INC

NPI #1225237993 in Raytown, Missouri

Provider Information

NPI Number: 1225237993
Entity Type: Organization
Organization Name: Individual Expressions, INC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jul 13, 2007
Last Updated: Jul 13, 2007

Practice Location

Address: 3817 WOODSON DRIVE
City: Raytown
State: Missouri
ZIP Code: 64138
Phone: (816) 509-5509

Authorized Official

Name: MR. MARK ROBERT FORTIN
Title: PRESIDENT
Phone: (816) 509-5509

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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