Healthcare Provider Details

I. General information

NPI: 1699726380
Provider Name (Legal Business Name): KANSAS CITY HOSPICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 STATE LINE RD STE 300
KANSAS CITY MO
64114-3212
US

IV. Provider business mailing address

9001 STATE LINE RD STE 300
KANSAS CITY MO
64114-3212
US

V. Phone/Fax

Practice location:
  • Phone: 816-363-2600
  • Fax: 816-523-0068
Mailing address:
  • Phone: 816-363-2600
  • Fax: 816-523-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID WILEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 816-363-2600