Individual provider · Type 1 NPI
Latundra R. Butler
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Overland Park, KS
Practice location
14013 Garnett St
Overland Park, KS 66221-2807
Mailing address
1415 NE Amanda Jean Way
Grain Valley, MO 64029-7838
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | 10063429 (MO) |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
About NPI 1104013754
Latundra R. Butler's National Provider Identifier is 1104013754, issued on Sep 27, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Overland Park, KS. The record was last updated on Jul 18, 2012.