NPI 1437319530

Dominicks Group Home LLC

Organisation Developmentally Disabled Services Day Training Agency Lees Summit, MO

Practice location

Address: 1112 SW Whistle Dr, Lees Summit, MO 64082-4876
Phone: (816) 623-3403

Authorised official

Name: Phyllis Ann Green
Title: Administrator/Director
Phone: (816) 623-3403

Registered specialties

Developmentally Disabled Services Day Training Agency Primary

Agencies Taxonomy 251C00000X Licence N00856212 (MO)

Other Day Training, Developmentally Disabled Services providers in Missouri →

Registry record

NPI: 1437319530
Entity type: Organization
NPI issued: 11 Jun 2008
Record last updated: 11 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.