MEDICARE: LIFE UNLIMITED, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1538347083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE UNLIMITED, INC.

Provider Business Mailing Address
First Line	:	320 ARMOUR RD
Second Line	:
City	:	N KANSAS CITY
State	:	MO
Zip	:	64116-3515
Country	:	US
Telephone Number	:	816-474-3026
Fax Number	:	816-474-3029

Provider Business Practice Location Address
First Line	:	9705 WINSLOW PL
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-3268
Country	:	US
Telephone Number	:	816-531-6975
Fax Number	:

Authorized Official
Title or Position	:	V.P. OF UNLIMITED PROPERTY MANAGEME
Name	:	SANDRA JEANNE DEGASE
Credential	:
Telephone Number	:	816-781-4332

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	02/08/2019

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Directions to “LIFE UNLIMITED, INC. ” Practice Location

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