Provider Demographics
NPI:1255148698
Name:AMAZING INDEPENDENCE CARE LLC
Entity type:Organization
Organization Name:AMAZING INDEPENDENCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-277-4174
Mailing Address - Street 1:4540 NE 38TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64117-2332
Mailing Address - Country:US
Mailing Address - Phone:816-277-4174
Mailing Address - Fax:816-817-8572
Practice Address - Street 1:4540 NE 38TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64117-2332
Practice Address - Country:US
Practice Address - Phone:816-277-4174
Practice Address - Fax:816-817-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities