MEDICARE: ALL FAMILIES HEALTH CENTER, 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	207Q00000X	Family Medicine Physician	P9867	MD

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	:	1871826461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL FAMILIES HEALTH CENTER, LLC

Provider Business Mailing Address
First Line	:	4301 CLEVELAND AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130
Country	:	US
Telephone Number	:	816-921-6000
Fax Number	:	816-921-9028

Provider Business Practice Location Address
First Line	:	4301 CLEVELAND AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130
Country	:	US
Telephone Number	:	816-921-6000
Fax Number	:	816-921-9028

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ZELDA R. PORTER
Credential	:
Telephone Number	:	816-921-6000

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	10/02/2009

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