Healthcare Provider Details

I. General information

NPI: 1598956906
Provider Name (Legal Business Name): ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 REMINGTON PLAZA CT
RAYMORE MO
64083-8599
US

IV. Provider business mailing address

12127 BLUE RIDGE EXT SUIT C,H,I
GRANDVIEW MO
64030-6404
US

V. Phone/Fax

Practice location:
  • Phone: 816-767-0925
  • Fax: 816-761-1187
Mailing address:
  • Phone: 816-767-0925
  • Fax: 816-331-6565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. AISHA LADI WASHINGTON
Title or Position: EXECUTIVE DIRECTOR
Credential: MS,RD,LD
Phone: 816-767-0925