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General NPI Number Information
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NPI Number | 1770583684
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Entity Type | Organization
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Legal Business Name | MONTEREY PARK NURSING CENTER, INC
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 4600 LITTLE BLUE PKWY
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City | INDEPENDENCE
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State | MO
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Zip | 64057-8302
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Country | US
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Telephone | 816-795-7888
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Fax | 816-268-9981
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Provider Business Mailing Address
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Address Line | 4600 LITTLE BLUE PKWY
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City | INDEPENDENCE
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State | MO
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Zip | 64057-8302
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Country | US
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Telephone | 816-795-7888
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Fax | 816-268-9981
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | JOSEPH C TUTERA
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Credential |
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Telephone | 816-444-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 027551
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 027551
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License Number State | MO
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