Healthcare Provider Details

I. General information

NPI: 1538790977
Provider Name (Legal Business Name): LHW OP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 GLENN HENDREN DR
LIBERTY MO
64068-3375
US

IV. Provider business mailing address

525 CHESTNUT ST
CEDARHURST NY
11516-2223
US

V. Phone/Fax

Practice location:
  • Phone: 816-736-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAMUEL GOLDNER
Title or Position: AUTHORIZED PERSON
Credential:
Phone: 516-727-1634