Organization
GREEN LAKES VILLAGE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRON GARNER (EXECUTIVE DIRECTOR)
(314) 518-2663
Entity
Organization
Contact information
Practice address
1828 WALNUT ST FL 3, KANSAS CITY, MO 64108-1835
(314) 518-2663
Mailing address
1828 WALNUT ST FL 3, KANSAS CITY, MO 64108-1835
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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