Provider Demographics
NPI:1558707737
Name:OPEN DOORS ADULT DAY CARE SERVICES
Entity Type:Organization
Organization Name:OPEN DOORS ADULT DAY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:UKPABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-214-8065
Mailing Address - Street 1:13013 FULLER AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-2619
Mailing Address - Country:US
Mailing Address - Phone:816-214-8065
Mailing Address - Fax:816-214-8065
Practice Address - Street 1:13013 FULLER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-2619
Practice Address - Country:US
Practice Address - Phone:816-214-8065
Practice Address - Fax:816-214-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1111261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care