Provider Demographics
NPI:1386708592
Name:LITTLE SISTERS OF THE POOR
Entity type:Organization
Organization Name:LITTLE SISTERS OF THE POOR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SR. MARY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:POWER
Authorized Official - Suffix:
Authorized Official - Credentials:SISTER
Authorized Official - Phone:816-761-4744
Mailing Address - Street 1:8745 JAMES A REED RD
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4414
Mailing Address - Country:US
Mailing Address - Phone:816-761-4744
Mailing Address - Fax:816-761-8313
Practice Address - Street 1:8745 JAMES A REED RD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-4414
Practice Address - Country:US
Practice Address - Phone:816-761-4744
Practice Address - Fax:816-761-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO030725310400000X
MO030724313M00000X
MO030723314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26A292Medicare ID - Type Unspecified