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DISSOCIATIVE ASSOCIATES, LLC
NPI 1316658495
Clinic/Center - Infusion Therapy in Lees Summit, MO

Active since December 08, 2022
817 NE ANDERSON LN, LEES SUMMIT, MO 64064(816) 381-2050(816) 503-8271 Get Directions Write a Review

NPPES record last updated: December 8, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dissociative Associates, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DISSOCIATIVE ASSOCIATES, LLC (NPI 1316658495), doing business as Ketamine Clinic Rx, is a healthcare organization registered as an infusion therapy in Lees Summit, Missouri and active in the NPI registry since December 2022. The organization lists Robert Fansler, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1316658495
Entity TypeOrganization
Primary Taxonomy261QI0500X
Legal Business NameDISSOCIATIVE ASSOCIATES, LLC
Location Address817 NE ANDERSON LNLees Summit, MO 64064-1244
Mailing Address817 Ne Anderson LnLees Summit, MO 64064-1244 · (816) 381-2050
Phone(816) 381-2050
Fax(816) 503-8271
Organization SubpartNo
Authorized OfficialRobert FanslerOffice Manager · (816) 678-5969
Enumeration DateDecember 8, 2022
NPPES CertifiedDecember 8, 2022
✔ NPI 1316658495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Infusion TherapyAmbulatory Health Care Facilities
Taxonomy Code261QI0500X
817 NE ANDERSON LN, Lees Summit, MO 64064
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Other Names 1

Doing Business AsKetamine Clinic Rx

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dissociative Associates, LLC's NPI number?

The NPI number for Dissociative Associates, LLC is 1316658495. It was assigned to this organization in the NPPES registry on December 8, 2022. The provider is doing business as Ketamine Clinic RX.

Where is Dissociative Associates, LLC located?

Dissociative Associates, LLC is located at 817 NE Anderson Ln, Lees Summit, MO 64064. The listed phone number is (816) 381-2050.

What is Dissociative Associates, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Infusion Therapy, with taxonomy code 261QI0500X.

When was this NPI record last updated?

The NPPES record for Dissociative Associates, LLC was last updated on December 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.