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General NPI Number Information
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NPI Number | 1164798047
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Entity Type | Organization
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Legal Business Name | AFFINITY ADULT DAYCARE
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 18813 E 25TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2467
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Country | US
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Telephone | 816-898-7529
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Fax |
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Provider Business Mailing Address
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Address Line | 8540 BLUERIDGE
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City | RAYTOWN
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State | MO
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Zip | 64138-2959
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Country | US
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Telephone | 816-759-0112
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICE DUMAS VERAGUTH
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Credential |
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Telephone | 816-759-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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