NPIMap

Organization Active NPI

Kidz Connection Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kansas City, MO
National Provider Identifier
1740489517
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
KIDZ CONNECTION GROUP HOME
Doing business as
Jackson Style Agency
Practice address
11815 Beacon Ave
Kansas City, MO 64134-3708
Phone
(816) 763-8335
Fax
(816) 765-9987
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Mr. Cleotha Jackson
Title
Asst. Administrator
Phone
(816) 765-9990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

11815 Beacon Ave
Kansas City, MO 64134-3708

Mailing address

213 Blue Ridge Ext
Grandview, MO 64030-1604
Phone (816) 765-9990

Other names 1

  • Jackson Style Agency Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kidz Connection Group Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1740489517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 BLUE RIDGE EXT",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301604",
            "telephone_number": "816-765-9990",
            "fax_number": "816-765-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11815 BEACON AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641343708",
            "telephone_number": "816-763-8335",
            "fax_number": "816-765-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ CONNECTION GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CLEOTHA",
        "authorized_official_title_or_position": "ASST. ADMINISTRATOR",
        "authorized_official_telephone_number": "816-765-9990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Style Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.

Verify at the official NPI Registry.