Provider Demographics
NPI:1932940996
Name:OVERLAND PARK SNF HEALTHCARE LLC
Entity type:Organization
Organization Name:OVERLAND PARK SNF HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LEGAL RISK MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-342-5175
Mailing Address - Street 1:262 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2975
Mailing Address - Country:US
Mailing Address - Phone:385-518-1814
Mailing Address - Fax:
Practice Address - Street 1:5211 W 103RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-3154
Practice Address - Country:US
Practice Address - Phone:913-383-2569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility