Provider Demographics
NPI:1528430188
Name:CROW, SHERYL
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:CROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 NE 113TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2923
Mailing Address - Country:US
Mailing Address - Phone:816-734-5858
Mailing Address - Fax:816-734-5311
Practice Address - Street 1:1606 NE 113TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2923
Practice Address - Country:US
Practice Address - Phone:816-734-5858
Practice Address - Fax:816-734-5311
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities