Healthcare Provider Details

I. General information

NPI: 1841246154
Provider Name (Legal Business Name): MIDWEST DIVISION - MMC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 W 119TH ST
OVERLAND PARK KS
66209-3722
US

IV. Provider business mailing address

5721 W 119TH ST
OVERLAND PARK KS
66209-3722
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-6000
  • Fax: 913-498-7106
Mailing address:
  • Phone: 913-498-6000
  • Fax: 913-498-7106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE GAFFORD
Title or Position: CFO
Credential:
Phone: 913-498-6769