Organization
WATERFORD SOUTH ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALFREDO E. EGBADON (ADMINISTRATOR)
(816) 942-4898
Entity
Organization
Contact information
Practice address
11515 HOLMES RD, KANSAS CITY, MO 64131-3856
(816) 942-4898
(816) 942-3278
Mailing address
11515 HOLMES RD, KANSAS CITY, MO 64131-3856
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
251E00000X
MO
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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