MEDICARE: VILLAGES OF CHRIST

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	347C00000X	Private Vehicle	B105	KS
2	385H00000X	Respite Care	B105	KS
3	311ZA0620X	Adult Care Home Facility	B0105	KS

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	:	1508171307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGES OF CHRIST

Provider Business Mailing Address
First Line	:	155 S 18TH ST
Second Line	:	#111
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5642
Country	:	US
Telephone Number	:	913-602-8480
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 S 18TH ST
Second Line	:	#111
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5642
Country	:	US
Telephone Number	:	913-602-8480
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SELENA MUSCHELLE OVERTON
Credential	:
Telephone Number	:	913-638-0523

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	08/17/2010

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1972797868 — REGINA ELEANOR SINGLETON LMSW
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1982917407 — MRS. AMY ALISON CHEUNG
Practice Location Address:

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Directions to “VILLAGES OF CHRIST ” Practice Location

Language	Start Address	Practice Location

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