- Enrollment id
- O20130820000914
- Enrollment state
- MO
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1679910376
- Multiple npi flag
- N
- Ccn
- 261653
- Associate id
- 2769391820
- Organization name
- INTERIM HEALTHCARE OF KANSAS CITY, INC
- Incorporation date
- 1975-06-02
- Incorporation state
- MO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3131 S STATE ROUTE 291
- Address line 2
- STE C
- City
- INDEPENDENCE
- State
- MO
- Zip code
- 640572645