Healthcare Provider Details

I. General information

NPI: 1194139246
Provider Name (Legal Business Name): HMONG ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 N. 69TH STREET
KANSAS CITY KS
66109
US

IV. Provider business mailing address

2617 N. 69TH STREET
KANSAS CITY KS
66109
US

V. Phone/Fax

Practice location:
  • Phone: 913-334-2427
  • Fax:
Mailing address:
  • Phone: 913-334-2427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateKS

VIII. Authorized Official

Name: MRS. DIA L HERR
Title or Position: OWNER
Credential:
Phone: 913-334-2427