| Melo Enterprises Llc | |
|
119 Ne 72nd St Gladstone MO 64118-1826 | |
| (913) 568-5530 | |
| Not Available |
| Full Name | Melo Enterprises Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 12/23/2022 |
| Certification Date | 12/23/2022 |
| Medicare PECOS PAC ID | 2365868692 |
|---|---|
| Medicare Enrollment ID | O20200818001921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073125589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Melissa M Oeffner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376082446 PECOS PAC ID: 6406131549 Enrollment ID: I20170403000046 |
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