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General NPI Number Information
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NPI Number | 1053450825
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Entity Type | Organization
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Legal Business Name | ADAMS ACTIVELY AGING INC.
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 3145 SYLVANIE ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-3322
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Country | US
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Telephone | 816-671-0032
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Fax |
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Provider Business Mailing Address
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Address Line | 3145 SYLVANIE ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-3322
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Country | US
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Telephone | 816-671-0031
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Fax |
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Authorized Official
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Title or Position | VP MANAGER
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Name | MR. CHARLES DAVID ADAMS
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Credential |
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Telephone | 816-671-0031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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