MEDICARE: SHAREDLIVINGKC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1003517160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAREDLIVINGKC

Provider Business Mailing Address
First Line	:	2917 N 38TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66104-2527
Country	:	US
Telephone Number	:	913-499-1097
Fax Number	:	913-499-1098

Provider Business Practice Location Address
First Line	:	2917 N 38TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66104-2527
Country	:	US
Telephone Number	:	913-499-1097
Fax Number	:	913-499-1098

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. KEVIN BROWN
Credential	:
Telephone Number	:	702-344-7014

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	03/15/2023

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Directions to “SHAREDLIVINGKC ” Practice Location

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