MEDICARE: THE SAILS GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	253Z00000X	In Home Supportive Care Agency	KS
2	261QD1600X	Developmental Disabilities Clinic/Center	KS
3	103K00000X	Behavior Analyst
4	106E00000X	Assistant Behavior Analyst
5	106S00000X	Behavior Technician
6	251B00000X	Case Management Agency	KS
7	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	KS

General Provider Information

NPI Number	:	1689113326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SAILS GROUP, INC.

Provider Business Mailing Address
First Line	:	20058 VENTURA BLVD # 53
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2637
Country	:	US
Telephone Number	:	760-631-7550
Fax Number	:	760-650-0222

Provider Business Practice Location Address
First Line	:	7540 LEAVENWORTH RD STE 5A
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-1239
Country	:	US
Telephone Number	:	816-249-2027
Fax Number	:	913-214-1960

Authorized Official
Title or Position	:	CEO
Name	:	MR. IHAB SHAHAWI
Credential	:
Telephone Number	:	657-206-9594

Provider Enumeration Date	:	02/14/2017
Last Update Date	:	03/29/2018

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Directions to “THE SAILS GROUP, INC. ” Practice Location

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