MEDICARE: ASSURED CARE LLC

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	261QA0600X	Adult Day Care Clinic/Center		MO

General Provider Information

NPI Number	:	1255515060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED CARE LLC

Provider Business Mailing Address
First Line	:	4513 E 60TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-4618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4513 E 60TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-4618
Country	:	US
Telephone Number	:	816-813-4614
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	ANGELA CAHILL
Credential	:
Telephone Number	:	816-813-4614

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	12/28/2007

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