Provider Demographics
NPI:1386121507
Name:ST LUKES HOSPITAL OF KANSAS CITY
Entity type:Organization
Organization Name:ST LUKES HOSPITAL OF KANSAS CITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NACHTIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-932-9886
Mailing Address - Street 1:10918 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-4108
Mailing Address - Country:US
Mailing Address - Phone:816-765-6600
Mailing Address - Fax:
Practice Address - Street 1:10918 ELM AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-4108
Practice Address - Country:US
Practice Address - Phone:816-765-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST LUKES HOSPITAL OF KANSAS CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-20
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO295-38323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MONONEOtherNONE