Provider Demographics
NPI:1083921514
Name:CASS COUNTY CENTER FOR SENIORS & SPECIAL NEEDS
Entity Type:Organization
Organization Name:CASS COUNTY CENTER FOR SENIORS & SPECIAL NEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:LADI
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD,LD
Authorized Official - Phone:816-331-6565
Mailing Address - Street 1:414 REMINGTON PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8599
Mailing Address - Country:US
Mailing Address - Phone:816-331-6565
Mailing Address - Fax:
Practice Address - Street 1:414 REMINGTON PLAZA CT
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8599
Practice Address - Country:US
Practice Address - Phone:816-331-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT DAY CARE HEALTH CENTER OF GREATER KANSAS CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-03
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO882261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261QA0600XMedicaid