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General NPI Number Information
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NPI Number | 1871858746
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Entity Type | Organization
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Legal Business Name | DELORES HOMES
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 6613 PARALLEL AVE
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City | KANSAS CITY
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State | KS
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Zip | 66102-1046
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Country | US
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Telephone | 913-299-9534
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Fax | 913-299-9531
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Provider Business Mailing Address
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Address Line | 6613 PARALLEL AVE
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City | KANSAS CITY
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State | KS
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Zip | 66102-1046
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Country | US
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Telephone | 913-299-9534
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Fax | 913-299-9531
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BRIANNE PATRICSE FORD
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Credential | PHD(C)
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Telephone | 913-299-9534
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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 | A-105-017
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License Number State | KS
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