MEDICARE: REDEMPTION CONSUMER DIRECTED SERVICES

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	:	1194153692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDEMPTION CONSUMER DIRECTED SERVICES

Provider Business Mailing Address
First Line	:	8130 HOLMES RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-2145
Country	:	US
Telephone Number	:	816-974-8057
Fax Number	:	816-301-7524

Provider Business Practice Location Address
First Line	:	8130 HOLMES RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-2145
Country	:	US
Telephone Number	:	816-974-8057
Fax Number	:	816-301-7524

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	THUSTON L. PACKNETT SR.
Credential	:
Telephone Number	:	816-974-8057

Provider Enumeration Date	:	10/17/2013
Last Update Date	:	10/17/2013

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Directions to “REDEMPTION CONSUMER DIRECTED SERVICES ” Practice Location

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