Betty Lou Wallace Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BETTY LOU WALLACE RECOVERY LLC

Practice address

13643 Holmes Rd
Kansas City, MO 64145-1482

Phone

(480) 388-1495

NPI assigned

Feb 18, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Geffen Liberman

Title

Executive Director

Phone

(480) 388-1495

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Betty Lou Wallace Recovery LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Betty Lou Wallace Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kansas City, MO
  • NPI 1104417419
  NPD tax ID
• Betty Lou Wallace Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kansas City, MO
  • NPI 1225496052
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1366035594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13340 HOLMES RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641451437",
            "telephone_number": "816-786-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13643 HOLMES RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641451482",
            "telephone_number": "480-388-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTY LOU WALLACE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "LIBERMAN",
        "authorized_official_first_name": "GEFFEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-388-1495"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Billiard Group Home
• Betty Billiard Group Home
• Betty Lou Wallace Recovery
• Betty Lou Wallace Recovery LLC
• Betty Lou Wallace Recovery LLC
• Jack Edward Beuerlein, DDS
• Evelyn Beussink, LPC
• Pamela Marie Bevan, ARNP, RN
• Adrienne Bevel-Garcia
• Kathryne Suzanne Bever, PT, DPT

• All providers in Kansas City, MO
• Substance Abuse Rehabilitation Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.