Provider Demographics
NPI:1346464369
Name:KENDALLWOOD SENIOR PROPERTIES, LLC
Entity Type:Organization
Organization Name:KENDALLWOOD SENIOR PROPERTIES, LLC
Other - Org Name:KENDALLWOOD SENIOR PROPERTIES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:THOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-492-7800
Mailing Address - Street 1:9216 BOND
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214
Mailing Address - Country:US
Mailing Address - Phone:913-492-7800
Mailing Address - Fax:913-492-7801
Practice Address - Street 1:2801 NE 60TH ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-2040
Practice Address - Country:US
Practice Address - Phone:816-454-7755
Practice Address - Fax:816-454-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO033910310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility