| Midwest Innovative Health Inc | |
|
409 Se Douglas St Lees Summit MO 64063 | |
| (816) 578-4548 | |
| (816) 774-8132 |
| Full Name | Midwest Innovative Health Inc |
|---|---|
| Speciality | Social Worker |
| Location | 409 Se Douglas St, Lees Summit, Missouri |
| Authorized Official Name and Position | Stacey M Deister (MANAGER) |
| Authorized Official Contact | 8163654070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Innovative Health Inc 99 Z St Lake Lotawana MO 64086-9769 Ph: (816) 578-4548 | Midwest Innovative Health Inc 409 Se Douglas St Lees Summit MO 64063 Ph: (816) 578-4548 |
| NPI Number | 1134607369 |
|---|---|
| Provider Enumeration Date | 07/31/2018 |
| Last Update Date | 08/08/2018 |
| Medicare PECOS PAC ID | 9436579349 |
|---|---|
| Medicare Enrollment ID | O20201014003713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134607369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Charles F Foshee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306901210 PECOS PAC ID: 8527152271 Enrollment ID: I20070926000111 |
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