Healthcare Provider Details

I. General information

NPI: 1063549830
Provider Name (Legal Business Name): AURORA MAJIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11207 CLEVELAND AVE
KANSAS CITY MO
64137-2306
US

IV. Provider business mailing address

4910 GRANDVIEW RD
KANSAS CITY MO
64137-1939
US

V. Phone/Fax

Practice location:
  • Phone: 816-965-8657
  • Fax: 816-965-8659
Mailing address:
  • Phone: 816-965-0901
  • Fax: 816-965-9017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. JAN SMITH
Title or Position: DIRECTOR
Credential:
Phone: 816-965-0901