Healthcare Provider Details

I. General information

NPI: 1255520474
Provider Name (Legal Business Name): ALLIANCE PERSONAL CARE. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 E. US HWY 40
INDEPENDENCE MO
64055
US

IV. Provider business mailing address

1831 MINNESOTA AVENUE
KANSAS CITY KS
66102
US

V. Phone/Fax

Practice location:
  • Phone: 816-743-0113
  • Fax: 816-743-0193
Mailing address:
  • Phone: 816-743-0013
  • Fax: 816-743-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: MR. JORDAN ADAM VAN RY
Title or Position: COO
Credential:
Phone: 913-233-0160