Provider Demographics
NPI:1326438540
Name:STRATFORD COMMONS REHABILITATION & HEALTH CARE CENTER, L.L.C
Entity Type:Organization
Organization Name:STRATFORD COMMONS REHABILITATION & HEALTH CARE CENTER, L.L.C
Other - Org Name:STRATFORD COMMONS REHABILITATION & HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:TUTERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-444-0900
Mailing Address - Street 1:12340 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2408
Mailing Address - Country:US
Mailing Address - Phone:913-851-0215
Mailing Address - Fax:913-851-8675
Practice Address - Street 1:12340 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2408
Practice Address - Country:US
Practice Address - Phone:913-851-0215
Practice Address - Fax:913-851-8675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN046097314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSN046097Medicaid
175549Medicare Oscar/Certification