1972247625 NPI number — DELORES HOMES - HOME HEALTH AGENCY

Table of content: (NPI 1972247625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972247625 NPI number — DELORES HOMES - HOME HEALTH AGENCY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DELORES HOMES - HOME HEALTH AGENCY
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:
1972247625
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7735 WASHINGTON AVE STE F
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:
66112-2469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-299-9534
Provider Business Mailing Address Fax Number:
913-299-9531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7735 WASHINGTON AVE STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66112-2469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-299-9534
Provider Business Practice Location Address Fax Number:
913-299-9531
Provider Enumeration Date:
04/27/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NZIOKI
Authorized Official First Name:
FRANCES
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
913-299-9534

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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