Provider Demographics
NPI:1306011390
Name:MANLOVE, ADDIE LEE
Entity Type:Individual
Prefix:MRS
First Name:ADDIE
Middle Name:LEE
Last Name:MANLOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1642
Mailing Address - Country:US
Mailing Address - Phone:816-822-1788
Mailing Address - Fax:816-822-1788
Practice Address - Street 1:7443 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1642
Practice Address - Country:US
Practice Address - Phone:816-822-1788
Practice Address - Fax:816-822-1788
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child