Healthcare Provider Details

I. General information

NPI: 1801184593
Provider Name (Legal Business Name): SEASONS SPECIALTY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 07/14/2011
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 TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number815
License Number StateMO

VIII. Authorized Official

Name: MR. ROBERT H ROGERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 816-478-4757