Momentum Behavioral Health Associates, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MOMENTUM BEHAVIORAL HEALTH ASSOCIATES, INC

Practice address

705B SE Melody LN
Suite 112
Lees Summit, MO 64063-4380

Phone

(816) 457-3899

Fax

(888) 482-2151

NPI assigned

Jan 7, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Annette K Griffith, BCBA-D

Title

Director

Phone

(816) 457-3899

Specialties & licenses 2

Addresses

Other names 1

• Momentum Behavioral Health Doing business as

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1902143282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705B SE MELODY LN",
            "address_2": "SUITE 112",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634380",
            "telephone_number": "816-457-3899",
            "fax_number": "888-482-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705B SE MELODY LN",
            "address_2": "SUITE 112",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634380",
            "telephone_number": "816-457-3899",
            "fax_number": "888-482-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM BEHAVIORAL HEALTH ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "816-457-3899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BCBA-D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2011003585",
            "primary": false
        },
        {
            "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": "Momentum Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.