Healthcare Provider Details

I. General information

NPI: 1235436593
Provider Name (Legal Business Name): OMONOSA TRANSPORTATION AND SOCIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 PROSPECT AVE
KANSAS CITY MO
64130
US

IV. Provider business mailing address

PO BOX 411155
KANSAS CITY MO
64141-1155
US

V. Phone/Fax

Practice location:
  • Phone: 816-875-6090
  • Fax:
Mailing address:
  • Phone: 816-547-3710
  • Fax: 816-437-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1505
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOY NNEKA EKE
Title or Position: ASST EXCUT DIRECTOR/ SECRETARYNURSE
Credential: APRN
Phone: 816-547-3710