Provider Demographics
NPI:1306335328
Name:ANTHEM OVERLAND PARK MANAGEMENT, LLC
Entity type:Organization
Organization Name:ANTHEM OVERLAND PARK MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:913-901-8500
Mailing Address - Street 1:6921 W 81ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-3913
Mailing Address - Country:US
Mailing Address - Phone:913-901-8500
Mailing Address - Fax:913-901-8505
Practice Address - Street 1:6921 W 81ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-3913
Practice Address - Country:US
Practice Address - Phone:913-901-8500
Practice Address - Fax:913-901-8505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMC-OVERLAND PARK, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN046083311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home