Melo Enterprises Llc | |
119 Ne 72nd St Gladstone MO 64118-1826 | |
(913) 568-5530 | |
Not Available |
Full Name | Melo Enterprises Llc |
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Speciality | Clinic/Center |
Location | 119 Ne 72nd St, Gladstone, Missouri |
Authorized Official Name and Position | Melissa Marie Oeffner (OWNER) |
Authorized Official Contact | 9135685530 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Melo Enterprises Llc 15700 Kentucky Rd Belton MO 64012-5416 Ph: (913) 568-5530 | Melo Enterprises Llc 119 Ne 72nd St Gladstone MO 64118-1826 Ph: (913) 568-5530 |
NPI Number | 1073125589 |
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Provider Enumeration Date | 08/18/2020 |
Last Update Date | 12/23/2022 |
Certification Date | 12/23/2022 |
Medicare PECOS PAC ID | 2365868692 |
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Medicare Enrollment ID | O20200818001921 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073125589 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Melissa M Oeffner |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1376082446 PECOS PAC ID: 6406131549 Enrollment ID: I20170403000046 |
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