Provider Demographics
NPI:1003042862
Name:NGOZIKA NATIONAL MEMORIAL ASSOCIATION INC
Entity Type:Organization
Organization Name:NGOZIKA NATIONAL MEMORIAL ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IFEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSUALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-569-4801
Mailing Address - Street 1:11601 BENNINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-3714
Mailing Address - Country:US
Mailing Address - Phone:816-569-4801
Mailing Address - Fax:816-569-4801
Practice Address - Street 1:11601 BENNINGTON AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-3714
Practice Address - Country:US
Practice Address - Phone:816-569-4801
Practice Address - Fax:816-569-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO816311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home