| NPI | 1659183119 |
|---|---|
| Doing Business As | 87TH STREET PLACE |
| Entity Type | Organization |
| Authorized Contact | ESSENCE MONTGOMERY CFO 816-599-5683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-03-07 |