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General NPI Number Information
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NPI Number | 1306335328
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Entity Type | Organization
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Legal Business Name | ANTHEM OVERLAND PARK MANAGEMENT, LLC
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 6921 W 81ST ST
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City | OVERLAND PARK
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State | KS
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Zip | 66204-3913
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Country | US
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Telephone | 913-901-8500
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Fax | 913-901-8505
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Provider Business Mailing Address
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Address Line | 6921 W 81ST ST
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City | OVERLAND PARK
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State | KS
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Zip | 66204-3913
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Country | US
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Telephone | 913-901-8500
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Fax | 913-901-8505
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. HOWARD J TURLEY
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Credential | LNHA
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Telephone | 913-901-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | N046083
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License Number State | KS
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