Healthcare Provider Details

I. General information

NPI: 1144969932
Provider Name (Legal Business Name): ASPIRE SENIOR LIVING EXCELSIOR SPRINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 MEADOWLARK LN
EXCELSIOR SPRINGS MO
64024-3304
US

IV. Provider business mailing address

19401 E US HIGHWAY 40 STE 120
INDEPENDENCE MO
64055-5400
US

V. Phone/Fax

Practice location:
  • Phone: 816-630-3145
  • Fax:
Mailing address:
  • Phone: 816-957-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID STADTMUELLER
Title or Position: CFO
Credential:
Phone: 816-957-1010