Phoenix Isl
NPI #1831248012 in Harrisonville, Missouri
Provider Information
- NPI Number
- 1831248012
- Entity Type
- Organization
- Organization Name
- Phoenix Isl
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jan 9, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 26823 S BROOKHART DR
- City
- Harrisonville
- State
- Missouri
- ZIP Code
- 64701-6357
- Phone
- (816) 380-0723
Authorized Official
- Name
- MR. DALE KILGORE
- Title
- PROVIDER
- Phone
- (816) 380-0723
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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