Paseo Clinic

LBN: State Of Missouri
Paseo Clinic is an health care organization with primary practice located at 1000 E 24Th St , Kansas City MO 64108-2776. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, which is considered as the primary health care specialty. State Of Missouri can be contacted via phone (816) 512-7143, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
1000 E 24Th St Kansas City MO 64108-2776
Phone: (816) 512-7143
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X EXEMPT Missouri

Profile Details

NPI number 1609954809
LBN Legal business name State Of Missouri
DBA Doing business as Paseo Clinic
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 2nd, 2006
Last updated Oct 27th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609954809 NPPES
Missouri MEDICAID 866205800

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