Provider Demographics
NPI:1144507666
Name:DRUMM CENTER FOR CHILDREN, INC.
Entity type:Organization
Organization Name:DRUMM CENTER FOR CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOEHR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ACSW
Authorized Official - Phone:816-373-3434
Mailing Address - Street 1:3210 S LEES SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-1998
Mailing Address - Country:US
Mailing Address - Phone:816-373-3434
Mailing Address - Fax:816-373-3939
Practice Address - Street 1:3210 S LEES SUMMIT RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-1998
Practice Address - Country:US
Practice Address - Phone:816-373-3434
Practice Address - Fax:816-373-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-11
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000582472322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1851573828Medicaid
MO41853016OtherBLUE CROSS BLUE SHIELD