Provider Demographics
NPI:1215009295
Name:MPSS HOME CARE OF KC, INC.
Entity Type:Organization
Organization Name:MPSS HOME CARE OF KC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-350-2600
Mailing Address - Street 1:4215 S HOCKER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4723
Mailing Address - Country:US
Mailing Address - Phone:816-350-2600
Mailing Address - Fax:816-350-3405
Practice Address - Street 1:4215 S HOCKER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4723
Practice Address - Country:US
Practice Address - Phone:816-350-2600
Practice Address - Fax:816-350-3405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00010605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267539Medicare ID - Type UnspecifiedHOME HEALTH AGENCY