Mulberry Street Tbi, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MULBERRY STREET TBI, LLC

Practice address

1517 SW State Route 7
Blue Springs, MO 64014-3944

Phone

(816) 224-2000

Fax

(816) 224-2006

NPI assigned

Jan 29, 2013

Organization subpart

Yes

Parent organization

MULBERRY STREETAs reported in NPPES

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

Authorized official

Name

Mr. Joshua Aaron Mack

Title

Co-Director

Phone

(816) 224-2000

Specialties & licenses 1

Addresses

Part of

Mulberry Street LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Mulberry Street LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Blue Springs, MO
  • NPI 1902099013
  NPPES parent name

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1851639645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 SW STATE ROUTE 7",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143944",
            "telephone_number": "816-224-2000",
            "fax_number": "816-224-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 SW STATE ROUTE 7",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143944",
            "telephone_number": "816-224-2000",
            "fax_number": "816-224-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY STREET TBI, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MULBERRY STREET",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "816-224-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin L Moser, PT
• Megan Lynn Moss
• Mark Alan Mozer, MD
• Chrispinus Blaise Muga
• Mulberry Street LLC
• Emma Mullen, PTA
• Dean Lee Mundhenke, M.D.
• Kevin Munger, D.O.
• Chadia Mupenda
• Rachel Murdock

• In Home Supportive Care Agency in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.