1255520474 NPI number — ALLIANCE PERSONAL CARE. INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255520474 NPI number — ALLIANCE PERSONAL CARE. INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIANCE PERSONAL CARE. INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255520474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1831 MINNESOTA AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-743-0013
Provider Business Mailing Address Fax Number:
816-743-0193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9720 E. US HWY 40
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDEPENDENCE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-743-0113
Provider Business Practice Location Address Fax Number:
816-743-0193
Provider Enumeration Date:
10/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VAN RY
Authorized Official First Name:
JORDAN
Authorized Official Middle Name:
ADAM
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
913-233-0160

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 286339502-266339506 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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