MEDICARE: CARING ADULT DAYCARE 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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1962797340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING ADULT DAYCARE LLC

Provider Business Mailing Address
First Line	:	3742 N 113TH ST
Second Line	:	KANSAS CITY
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-3498
Country	:	US
Telephone Number	:	913-271-3763
Fax Number	:

Provider Business Practice Location Address
First Line	:	3742 N 113TH ST
Second Line	:	KANSAS CITY
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-3498
Country	:	US
Telephone Number	:	913-271-3763
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ALBERT O FAKEYE
Credential	:
Telephone Number	:	913-271-3763

Provider Enumeration Date	:	06/14/2011
Last Update Date	:	06/14/2011

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