| Clj Foundation | |
|
2311 N 102nd St Kansas City KS 66109-3612 | |
| (913) 208-4406 | |
| (913) 328-1646 |
| Full Name | Clj Foundation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2311 N 102nd St, Kansas City, Kansas |
| Authorized Official Name and Position | Connie Lee Johnson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9132084406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clj Foundation 2311 N 102nd St Kansas City KS 66109-3612 Ph: (913) 208-4406 | Clj Foundation 2311 N 102nd St Kansas City KS 66109-3612 Ph: (913) 208-4406 |
| NPI Number | 1467889311 |
|---|---|
| Provider Enumeration Date | 10/07/2013 |
| Last Update Date | 10/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467889311 | NPI | - | NPPES |
| 200251220A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Kansas) | Primary |
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