Provider Demographics
NPI:1588328579
Name:ACADEMY OF ADDICTION SERVICES
Entity type:Organization
Organization Name:ACADEMY OF ADDICTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CRAADC, LCAC
Authorized Official - Phone:816-820-7739
Mailing Address - Street 1:1734 E 63RD ST STE 4
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3543
Mailing Address - Country:US
Mailing Address - Phone:816-820-7739
Mailing Address - Fax:
Practice Address - Street 1:1734 E 63RD ST STE 4
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3543
Practice Address - Country:US
Practice Address - Phone:816-820-7739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)