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General NPI Number Information
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NPI Number | 1265956064
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Entity Type | Organization
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Legal Business Name | GLENNON PLACE MANAGEMENT LLC
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 10/20/2017
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Provider Practice Location Address
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Address Line | 128 N HARDESTY AVE
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City | KANSAS CITY
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State | MO
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Zip | 64123-1404
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Country | US
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Telephone | 816-241-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 4655 W CHASE AVE
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1605
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Country | US
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Telephone | 847-262-3800
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | YOSEF MEYSTEL
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Credential |
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Telephone | 847-262-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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