Healthcare Provider Details

I. General information

NPI: 1841629193
Provider Name (Legal Business Name): OVERLAND PARK LTAC OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W SAM HOUSTON PKWY N SUITE 100
HOUSTON TX
77041-5161
US

IV. Provider business mailing address

6509 W 103RD ST
OVERLAND PARK KS
66212-1728
US

V. Phone/Fax

Practice location:
  • Phone: 832-467-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: THOMAS P SIMONS
Title or Position: SVP OPERATIONS FINANCE
Credential:
Phone: 678-443-7000