Healthcare Provider Details

I. General information

NPI: 1154742567
Provider Name (Legal Business Name): EAGLE CASE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2014
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7735 WASHINGTON AVE SUITE C
KANSAS CITY KS
66112-2444
US

IV. Provider business mailing address

7405 N CONGRESS AVE
KANSAS CITY MO
64152-2332
US

V. Phone/Fax

Practice location:
  • Phone: 816-746-6556
  • Fax: 816-746-6353
Mailing address:
  • Phone: 816-746-6556
  • Fax: 816-756-6353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK O NWANGUZO
Title or Position: OWNER
Credential:
Phone: 913-334-9035