Provider Demographics
NPI:1053584268
Name:SUPPORTING HEARTS
Entity type:Organization
Organization Name:SUPPORTING HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARSCHELLE
Authorized Official - Middle Name:TRE'NICCE
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-359-9202
Mailing Address - Street 1:3231 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64124-1927
Mailing Address - Country:US
Mailing Address - Phone:816-241-0465
Mailing Address - Fax:816-241-0465
Practice Address - Street 1:7344 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1912
Practice Address - Country:US
Practice Address - Phone:816-241-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities