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ST. KOLBE-PUCKETT CENTER FOR HEALING INC NPI 1114498698


NPI Information

NPI: 1114498698
Provider Name: ST. KOLBE-PUCKETT CENTER FOR HEALING INC
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 26D2261261

Address:
210 N 7TH ST
SAINT JOSEPH, MO
ZIP 64501
Phone: (816) 259-5318
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ST. KOLBE-PUCKETT CENTER FOR HEALING INC is an addiction medicine family medicine in Saint Joseph, MO. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. ST. KOLBE-PUCKETT CENTER FOR HEALING INC NPI is 1114498698. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

210 N 7TH ST
SAINT JOSEPH, MO
ZIP 64501-906
Phone: (816) 259-5318
Fax: (816) 259-5259

The provider's authorized official is Caroline Thalasinos .
The authorized official title is Office Manager and has the following contact phone number (816) 259-5318.

The CLIA number assigned to this NPI record is 26D2261261 - other - substance abuse outpatien with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2018 and was last updated on 5/1/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0401XFamily MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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