Active NPI
Side by Side II, Inc.
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Raytown, MO
National Provider Identifier
1740463231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- SIDE BY SIDE II, INC.
- Practice address
- 6612 Blue Ridge Boulevard
A
Raytown, MO 64133 - Phone
- (816) 356-0923
- Fax
- (816) 356-0925
- NPI assigned
- Dec 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Laura L Weisenborn
- Title
- President
- Phone
- (816) 356-0923
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
6612 Blue Ridge Boulevard
A
Raytown, MO 64133
Mailing address
6612 Blue Ridge Boulevard
A
Raytown, MO 64133
Phone (816) 356-0923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8558833401 | Medicaid | MO |
National Provider Directory
National Provider Directory- Tax ID family
- Side by Side II Inc
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmentally Disabled Services Day Training Agency
- Raytown, MO
- NPI 1144410663
-
- Home Health Agency
- Raytown, MO
- NPI 1508982752
-
- Developmentally Disabled Services Day Training Agency
- Lees Summit, MO
- NPI 1720269210
-
- Developmentally Disabled Services Day Training Agency
- Raytown, MO
- NPI 1962602664
Locations
6612 Blue Ridge Blvd
#A
Raytown, MO 64133
Phone (816) 356-0923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196985600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1196985600000",
"number": "1740463231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6612 BLUE RIDGE BOULEVARD",
"address_2": "A",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "64133",
"telephone_number": "816-356-0923",
"fax_number": "816-356-0925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6612 BLUE RIDGE BOULEVARD",
"address_2": "A",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "64133",
"telephone_number": "816-356-0923",
"fax_number": "816-356-0925"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SIDE BY SIDE II, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-07",
"last_updated": "2007-12-07",
"status": "A",
"authorized_official_last_name": "WEISENBORN",
"authorized_official_first_name": "LAURA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "816-356-0923"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8558833401",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raytown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.