Provider Demographics
NPI:1194153692
Name:REDEMPTION CONSUMER DIRECTED SERVICES
Entity type:Organization
Organization Name:REDEMPTION CONSUMER DIRECTED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THUSTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:PACKNETT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:816-974-8057
Mailing Address - Street 1:8130 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-2145
Mailing Address - Country:US
Mailing Address - Phone:816-974-8057
Mailing Address - Fax:816-301-7524
Practice Address - Street 1:8130 HOLMES RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-2145
Practice Address - Country:US
Practice Address - Phone:816-974-8057
Practice Address - Fax:816-301-7524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care