Provider Demographics
NPI:1215186051
Name:ADULT DAYCARING VILLAS, LLC.
Entity Type:Organization
Organization Name:ADULT DAYCARING VILLAS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:EVELYN
Authorized Official - Last Name:PORTER-LAMOTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-765-2273
Mailing Address - Street 1:11515 HICKMAN MILLS DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-4210
Mailing Address - Country:US
Mailing Address - Phone:816-765-2273
Mailing Address - Fax:816-765-2277
Practice Address - Street 1:11515 HICKMAN MILLS DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-4210
Practice Address - Country:US
Practice Address - Phone:816-765-2273
Practice Address - Fax:816-765-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO765261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care