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General NPI Number Information
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NPI Number | 1891842456
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Entity Type | Organization
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Legal Business Name | MANAGE CARE ASSISTED LIVING AGENCY INC.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 6724 TROOST AVE SUITE 105
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City | KANSAS CITY
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State | MO
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Zip | 64131-1500
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Country | US
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Telephone | 816-761-5122
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Fax | 816-444-0018
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Provider Business Mailing Address
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Address Line | 6724 TROOST AVE SUITE 105
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City | KANSAS CITY
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State | MO
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Zip | 64131-1500
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Country | US
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Telephone | 816-761-5122
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Fax | 816-444-0018
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. RUTH MARIA AHMED
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Credential |
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Telephone | 816-761-5122
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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 | 10042822
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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