Autis-Imagination LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Blue Springs, MO
NPI 1376780478 · NPPES record last updated Jan 11, 2009
Key facts
- NPI
- 1376780478
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- AUTIS-IMAGINATION LLC
- Practice address
- 1500 NW Mock Ave # C
Blue Springs, MO 64015-3095 - Phone
- (816) 213-6173
- Fax
- (816) 229-6997
- NPI assigned
- Jan 11, 2009
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lisa A. Grant, CCC-SLP
- Title
- Owner/SLP
- Phone
- (816) 213-6173
National Provider Directory
Locations
1500 NW Mock Ave
Ste C
Blue Springs, MO 64015
Phone (660) 624-0683
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
1500 NW Mock Ave # C
Blue Springs, MO 64015-3095
Mailing address
1500 NW Mock Ave # C
Blue Springs, MO 64015-3095
Phone (816) 213-6173
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 856253109 | Medicaid | MO |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.