Provider Demographics
NPI:1154025013
Name:PRAIRIE VIEW HEALTHCARE OF MISSOURI INC
Entity type:Organization
Organization Name:PRAIRIE VIEW HEALTHCARE OF MISSOURI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPORITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-515-8203
Mailing Address - Street 1:4551 PENNSYLVANIA AVE UNIT 1321
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3456
Mailing Address - Country:US
Mailing Address - Phone:913-515-8203
Mailing Address - Fax:913-273-1080
Practice Address - Street 1:1301 OAK ST STE 514
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-2804
Practice Address - Country:US
Practice Address - Phone:913-515-8203
Practice Address - Fax:913-273-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based