WATERFORD SOUTH ASSISTED LIVING NPI 1386837110

NPI Information

WATERFORD SOUTH ASSISTED LIVING is an assisted living facility in Kansas City, MO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. WATERFORD SOUTH ASSISTED LIVING NPI is 1386837110. The provider is registered as an organization entity type.

The provider's business location address is:

11515 HOLMES RD
KANSAS CITY, MO
ZIP 64131-856
Phone: (816) 942-4898
Fax: (816) 942-3278

The provider's authorized official is Alfredo E. Egbadon .
The authorized official title is Administrator and has the following contact phone number (816) 942-4898.

The CLIA number assigned to this NPI record is 26D0896980 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2007 and was last updated on 8/24/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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