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NPI Code Detail

MEDICARE: WILD-KAT ESTATES, LLC

MEDICARE: WILD-KAT ESTATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1598477119
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILD-KAT ESTATES, LLC
Provider Business Mailing Address
First Line : 12929 SE BIGHAM RD
Second Line :
City : STEWARTSVILLE
State : MO
Zip : 64490-8516
Country : US
Telephone Number : 660-728-2301
Fax Number :
Provider Business Practice Location Address
First Line : 300 W FAIRVIEW ST
Second Line :
City : KING CITY
State : MO
Zip : 64463-9606
Country : US
Telephone Number : 660-535-2011
Fax Number :
Authorized Official
Title or Position : OWNER/AUTHORIZED OFFICIAL
Name : STEPHANIE ANN STEINMAN
Credential :
Telephone Number : 660-728-2301
Provider Enumeration Date : 12/14/2022
Last Update Date : 12/14/2022

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Directions to “WILD-KAT ESTATES, LLC ” Practice Location

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