OrganizationActive
Individual Expressions, Inc
NPI 1225237993 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Raytown, MO
Provider details
- NPI number
- 1225237993
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mark Fortin, President(816) 509-5509
Specialties & taxonomies
Residential Treatment Facilities
Practice location
3817 Woodson Drive
Raytown, MO 64138
Phone: (816) 509-5509
Fax: (816) 356-1207
Approximate (ZIP-level) locationGet directions
Mailing address
507 Se 3rd St
Lees Summit, MO 64063-2810
Registry dates
- Enumerated
- 2007-07-13
- Last updated
- 2007-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.