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General NPI Number Information
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NPI Number | 1457476830
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Entity Type | Organization
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Legal Business Name | LIFE UNLIMITED, INC.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1525 BIRMINGHAM RD
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City | LIBERTY
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State | MO
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Zip | 64068-2767
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Country | US
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Telephone | 816-474-3026
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Fax | 816-474-3029
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Provider Business Mailing Address
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Address Line | 320 ARMOUR RD STE. 101
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City | N KANSAS CITY
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State | MO
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Zip | 64116-3506
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Country | US
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Telephone | 816-474-3026
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Fax | 816-474-3029
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Authorized Official
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Title or Position | VP UNLIMITED PROPERTY MANAGEMENT
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Name | SANDRA JEANNE DEGASE
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Credential |
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Telephone | 816-474-3026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 852755800
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License Number State | MO
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