| Kindred Light Support Llc | |
|
210 W 19th Ter Ste 150 Kansas City MO 64108-2162 | |
| (919) 998-9611 | |
| Not Available |
| Full Name | Kindred Light Support Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 210 W 19th Ter Ste 150, Kansas City, Missouri |
| Authorized Official Name and Position | Pierre Pickens (CEO) |
| Authorized Official Contact | 9199989611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kindred Light Support Llc Po Box 819 Carrboro NC 27510-0819 Ph: (919) 998-9611 | Kindred Light Support Llc 210 W 19th Ter Ste 150 Kansas City MO 64108-2162 Ph: (919) 998-9611 |
| NPI Number | 1669227427 |
|---|---|
| Provider Enumeration Date | 04/23/2024 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669227427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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