Healthcare Provider Details

I. General information

NPI: 1710039789
Provider Name (Legal Business Name): STRATFORD SPECIALTY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 WOODS CHAPEL RD
KANSAS CITY MO
64139-1354
US

IV. Provider business mailing address

15600 WOODS CHAPEL RD
KANSAS CITY MO
64139-1354
US

V. Phone/Fax

Practice location:
  • Phone: 816-478-4757
  • Fax: 816-478-8338
Mailing address:
  • Phone: 816-478-4757
  • Fax: 816-478-8338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number585
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number033210
License Number StateMO

VIII. Authorized Official

Name: MRS. SHELLY LEIGH MARONEY
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 816-478-4757