Healthcare Provider Details

I. General information

NPI: 1114651742
Provider Name (Legal Business Name): ANEW HEALTHCARE OPERATIONS - PLEASANTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 W 15TH ST
PLEASANTON KS
66075-4042
US

IV. Provider business mailing address

314 NW 11TH ST
BLUE SPRINGS MO
64015-3676
US

V. Phone/Fax

Practice location:
  • Phone: 913-352-6658
  • Fax:
Mailing address:
  • Phone: 417-399-3819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK HASTINGS
Title or Position: MANAGER
Credential:
Phone: 417-399-3819