MEDICARE: LIFE UNLIMITED, INC.

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	852755800	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457476830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE UNLIMITED, INC.

Provider Business Mailing Address
First Line	:	320 ARMOUR RD
Second Line	:	STE. 101
City	:	N KANSAS CITY
State	:	MO
Zip	:	64116-3506
Country	:	US
Telephone Number	:	816-474-3026
Fax Number	:	816-474-3029

Provider Business Practice Location Address
First Line	:	1525 BIRMINGHAM RD
Second Line	:
City	:	LIBERTY
State	:	MO
Zip	:	64068-2767
Country	:	US
Telephone Number	:	816-474-3026
Fax Number	:	816-474-3029

Authorized Official
Title or Position	:	VP UNLIMITED PROPERTY MANAGEMENT
Name	:	SANDRA JEANNE DEGASE
Credential	:
Telephone Number	:	816-474-3026

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	03/17/2018

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Directions to “LIFE UNLIMITED, INC. ” Practice Location

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