MEDICARE: LATREACE ANTHONY CNA

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	372600000X	Adult Companion	MO026850901879
2	373H00000X	Day Training/Habilitation Specialist	MO026850901879	MO
3	3747P1801X	Personal Care Attendant	MO026850901879	MO
4	374T00000X	Religious Nonmedical Nursing Personnel	MO026850901879	MO
5	385H00000X	Respite Care	MO026850901879	MO
6	376K00000X	Nurse's Aide	MO026850901879	MO
7	374U00000X	Home Health Aide	MO026850901879	MO
8	261QM0850X	Adult Mental Health Clinic/Center	MO026850901879	MO
9	146D00000X	Personal Emergency Response Attendant	MO026850901879	MO
10	311ZA0620X	Adult Care Home Facility	MO026850901879	MO
11	313M00000X	Nursing Facility/Intermediate Care Facility	MO026850901879	MO
12	332BX2000X	Oxygen Equipment & Supplies (DME)	MO026850901879	MO
13	372500000X	Chore Provider	MO026850901879	MO

General Provider Information

NPI Number	:	1639030109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATREACE ANTHONY CNA

Provider Business Mailing Address
First Line	:	1104 ASKEW AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64127-1521
Country	:	US
Telephone Number	:	816-335-7030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 ASKEW AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64127-1521
Country	:	US
Telephone Number	:	816-335-7030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	11/24/2025

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