1467491316 NPI number — RES-CARE KANSAS, INC.

Table of content: DR. LUISA FERNANDA RECIO DMD, MMSC (NPI 1386966356)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467491316 NPI number — RES-CARE KANSAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RES-CARE KANSAS, 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:
6
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:
1467491316
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
805 N WHITTINGTON PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40222-5186
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-394-2100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3919 SHERMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64506-3649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-671-1600
Provider Business Practice Location Address Fax Number:
816-671-1606
Provider Enumeration Date:
06/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHOBREY
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER ENROLLMENT
Authorized Official Telephone Number:
502-630-7249

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  A046098 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 6686 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0006371 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 268078607 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100112470P , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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