| Life Long Learning Center Incorporated | |
|
2400 Frederick Ave Suite 108 Saint Joseph MO 64506-2758 | |
| (816) 232-2514 | |
| (816) 232-5354 |
| Full Name | Life Long Learning Center Incorporated |
|---|---|
| Speciality | Social Worker |
| Location | 2400 Frederick Ave, Saint Joseph, Missouri |
| Authorized Official Name and Position | Ada L Silvy (PRESIDENT,OWNER) |
| Authorized Official Contact | 8162322514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Long Learning Center Incorporated 2400 Frederick Ave Suite 108 Saint Joseph MO 64506-2758 Ph: (816) 232-2514 | Life Long Learning Center Incorporated 2400 Frederick Ave Suite 108 Saint Joseph MO 64506-2758 Ph: (816) 232-2514 |
| NPI Number | 1932256708 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 05/17/2010 |
| Medicare PECOS PAC ID | 2769482843 |
|---|---|
| Medicare Enrollment ID | O20100928001221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932256708 | NPI | - | NPPES |
| 27016014 | Other | MO | BLUE CROSS BLUE SHIELD |
| 10001243000 | Other | MO | COMMUNITY HEALTH PLAN |
| 493600902 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 003482 (Missouri) | Primary |
| Provider Name | Ada L Silvy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932299146 PECOS PAC ID: 6305730649 Enrollment ID: I20040209001074 |
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