Provider Demographics
NPI:1528626371
Name:LADIES UNION BENEVOLENT ASSOCIATION
Entity type:Organization
Organization Name:LADIES UNION BENEVOLENT ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BUCKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-232-2675
Mailing Address - Street 1:101 FAR WEST DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3500
Mailing Address - Country:US
Mailing Address - Phone:816-232-2675
Mailing Address - Fax:816-233-4919
Practice Address - Street 1:101 FAR WEST DR
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3500
Practice Address - Country:US
Practice Address - Phone:816-232-2675
Practice Address - Fax:816-233-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO268222700Medicaid