MEDICARE: DELORES HOMES, LLC

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	251J00000X	Nursing Care Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1649888264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELORES HOMES, LLC

Provider Business Mailing Address
First Line	:	7735 WASHINGTON AVE
Second Line	:	SUITE F
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-2444
Country	:	US
Telephone Number	:	913-299-9534
Fax Number	:	913-299-9531

Provider Business Practice Location Address
First Line	:	7735 WASHINGTON AVE
Second Line	:	SUITE F
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-2444
Country	:	US
Telephone Number	:	913-299-9534
Fax Number	:	913-299-9531

Authorized Official
Title or Position	:	DIRECTOR
Name	:	FRANCES NZIOKI
Credential	:	RN
Telephone Number	:	913-230-1507

Provider Enumeration Date	:	07/20/2020
Last Update Date	:	07/20/2020

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