Provider Demographics
NPI:1598956906
Name:ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY
Entity Type:Organization
Organization Name:ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY
Other - Org Name:CASS COUNTY CENTER FOR SENIORS & SPECIAL NEEDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
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:816-767-0925
Mailing Address - Street 1:12127 BLUE RIDGE EXT
Mailing Address - Street 2:SUIT C,H,I
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-6404
Mailing Address - Country:US
Mailing Address - Phone:816-767-0925
Mailing Address - Fax:816-331-6565
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:816-767-0925
Practice Address - Fax:816-761-1187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT CARE HEALTH CENTER OF GREATER KANSAS CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-09
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO296132806Medicaid