| Diversify U | |
|
6512 N Oak Trfy Gladstone MO 64118-3329 | |
| (816) 935-7307 | |
| Not Available |
| Full Name | Diversify U |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6512 N Oak Trfy, Gladstone, Missouri |
| Authorized Official Name and Position | Fredick Leon Johnson (OWNER) |
| Authorized Official Contact | 8169357307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversify U 6512 N Oak Trfy Gladstone MO 64118-3329 Ph: () - | Diversify U 6512 N Oak Trfy Gladstone MO 64118-3329 Ph: (816) 935-7307 |
| NPI Number | 1538865050 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538865050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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