Provider Demographics
NPI:1184791824
Name:LIFE UNLIMITED, INC.
Entity type:Organization
Organization Name:LIFE UNLIMITED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-474-3026
Mailing Address - Street 1:320 ARMOUR RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3515
Mailing Address - Country:US
Mailing Address - Phone:816-474-3026
Mailing Address - Fax:
Practice Address - Street 1:4420 S 40TH ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64503-2157
Practice Address - Country:US
Practice Address - Phone:816-279-8558
Practice Address - Fax:816-279-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO266212307Medicaid