1598956906 NPI number — ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY

Table of content: (NPI 1598956906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598956906 NPI number — ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY
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:
CASS COUNTY CENTER FOR SENIORS & SPECIAL NEEDS
Provider Other Organization Name Type Code:
3
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:
1598956906
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12127 BLUE RIDGE EXT
Provider Second Line Business Mailing Address:
SUIT C,H,I
Provider Business Mailing Address City Name:
GRANDVIEW
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64030-6404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-767-0925
Provider Business Mailing Address Fax Number:
816-331-6565

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 REMINGTON PLAZA CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAYMORE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64083-8599
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-767-0925
Provider Business Practice Location Address Fax Number:
816-761-1187
Provider Enumeration Date:
08/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WASHINGTON
Authorized Official First Name:
AISHA
Authorized Official Middle Name:
LADI
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
816-767-0925

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 296132806 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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